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General NPI Number Information
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NPI Number | 1811353378
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Entity Type | Individual
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Provider Name | GEORGE ALAN PALM JR. OTR
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Gender | Male
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Dates
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Enumeration Date | 01/13/2016
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Last Update Date | 10/08/2019
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Provider Practice Location Address
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Address Line | 2406 E ASHBY RD
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City | MIDLAND
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State | MI
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Zip | 48640-8962
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Country | US
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Telephone | 989-600-0035
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Fax |
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Provider Business Mailing Address
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Address Line | 2406 E ASHBY RD
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City | MIDLAND
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State | MI
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Zip | 48640-8962
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Country | US
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Telephone | 989-600-0035
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 101134
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT16863
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 31006248A
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License Number State | IN
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Taxonomy #4
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT009574
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License Number State | OH
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Taxonomy #5
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 5201001447
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License Number State | MI
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