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General NPI Number Information
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NPI Number | 1831636570
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Entity Type | Organization
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Legal Business Name | BPALM, INC.
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Dates
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Enumeration Date | 01/19/2017
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Last Update Date | 01/19/2017
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Provider Practice Location Address
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Address Line | 1611 W WHISPERING WIND DR SUITE 4
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City | PHOENIX
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State | AZ
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Zip | 85085-0649
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Country | US
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Telephone | 602-345-1984
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Fax |
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Provider Business Mailing Address
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Address Line | 1611 W WHISPERING WIND DR SUITE 4
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City | PHOENIX
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State | AZ
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Zip | 85085-0649
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Country | US
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Telephone | 602-345-1984
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. BENJAMIN PALMER
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Credential | P.T., D.P.T.
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Telephone | 602-345-1984
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 11728
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License Number State | AZ
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