MEDICARE: PALMER CHIROPRACTIC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	DC30520	CA

General Provider Information

NPI Number	:	1699929570
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PALMER CHIROPRACTIC

Provider Business Mailing Address
First Line	:	3770 HIGHLAND AVE
Second Line	:	SUITE 105
City	:	MANHATTAN BEACH
State	:	CA
Zip	:	90266-3252
Country	:	US
Telephone Number	:	310-200-5995
Fax Number	:	310-546-8775

Provider Business Practice Location Address
First Line	:	3770 HIGHLAND AVE
Second Line	:	SUITE 105
City	:	MANHATTAN BEACH
State	:	CA
Zip	:	90266-3252
Country	:	US
Telephone Number	:	310-200-5995
Fax Number	:	310-546-8775

Authorized Official
Title or Position	:	OWNER
Name	:	DR. CHRISTOPHER PALMER
Credential	:	D.C.
Telephone Number	:	310-200-5995

Provider Enumeration Date	:	11/05/2008
Last Update Date	:	11/05/2008

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