Individual
MICHAEL PALM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
854 GALWAY LN, COLUMBIA, SC 29209-2037
(717) 341-4871
Mailing address
718 OLD MANOR RD, COLUMBIA, SC 29210-6563
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2000035438
—
2255A2300X
Athletic Trainer
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2127883
MERCER
—
Enumeration date
07/19/2019
Last updated
07/19/2019
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