Provider Demographics
NPI:1467551481
Name:SIMMER, MICHAEL (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:SIMMER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1607 WOODRUFF RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29607-6910
Mailing Address - Country:US
Mailing Address - Phone:864-458-8888
Mailing Address - Fax:864-458-8848
Practice Address - Street 1:1607 WOODRUFF RD
Practice Address - Street 2:SUITE 2
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-6910
Practice Address - Country:US
Practice Address - Phone:864-458-8888
Practice Address - Fax:864-458-8848
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3188111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC561793160OtherTAX ID