Provider Demographics
NPI:1568487056
Name:SCHIMIZZI, JASON MICHAEL (DC)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:MICHAEL
Last Name:SCHIMIZZI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:JASON
Other - Middle Name:MICHAEL
Other - Last Name:SLAGLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:99 W EISENHOWER DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:HANOVER
Mailing Address - State:PA
Mailing Address - Zip Code:17331-1152
Mailing Address - Country:US
Mailing Address - Phone:717-646-9922
Mailing Address - Fax:717-646-9666
Practice Address - Street 1:99 W EISENHOWER DR
Practice Address - Street 2:SUITE B
Practice Address - City:HANOVER
Practice Address - State:PA
Practice Address - Zip Code:17331-1152
Practice Address - Country:US
Practice Address - Phone:717-646-9922
Practice Address - Fax:717-646-9666
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2017-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC-007779-L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor