Provider Demographics
NPI:1871593681
Name:PALTER, LINDA CAROL (DC)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:CAROL
Last Name:PALTER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:857 W SUMMIT AVE
Mailing Address - Street 2:
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49441-4047
Mailing Address - Country:US
Mailing Address - Phone:231-755-3832
Mailing Address - Fax:231-755-3835
Practice Address - Street 1:857 W SUMMIT AVE
Practice Address - Street 2:
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49441-4047
Practice Address - Country:US
Practice Address - Phone:231-755-3832
Practice Address - Fax:231-755-3835
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-22
Last Update Date:2011-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301007892111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4536653Medicaid
MI4536653Medicaid
MIOM96130Medicare ID - Type Unspecified