Basic Information
Provider Information
NPI: 1821605585
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PALMER
FirstName: ADAM
MiddleName: S
NamePrefix:  
NameSuffix:  
Credential: PT, DPT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1200 CORPORATE DR STE 400
Address2:  
City: HOOVER
State: AL
PostalCode: 352425424
CountryCode: US
TelephoneNumber: 4232387217
FaxNumber: 4239331996
Practice Location
Address1: 1401 CONOWINGO RD STE C
Address2:  
City: BEL AIR
State: MD
PostalCode: 210141809
CountryCode: US
TelephoneNumber: 4104202257
FaxNumber: 4104202267
Other Information
ProviderEnumerationDate: 09/28/2020
LastUpdateDate: 09/28/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 09/28/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X28070MDY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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