Provider Demographics
NPI:1700761640
Name:PALMER, PAIGE (LMT)
Entity type:Individual
Prefix:
First Name:PAIGE
Middle Name:
Last Name:PALMER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 W MARISCAL RD APT 2
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92262-2936
Mailing Address - Country:US
Mailing Address - Phone:909-522-2472
Mailing Address - Fax:
Practice Address - Street 1:330 W MARISCAL RD APT 2
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-2936
Practice Address - Country:US
Practice Address - Phone:909-522-2472
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-08
Last Update Date:2025-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA44438225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist