Provider Demographics
NPI:1578723227
Name:SCHIRMER, MATTHEW (DC)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:
Last Name:SCHIRMER
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 1:2480 BROWNCROFT BLVD
Mailing Address - Street 2:SUITE 116
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14625-1435
Mailing Address - Country:US
Mailing Address - Phone:585-348-8858
Mailing Address - Fax:585-267-7538
Practice Address - Street 1:2480 BROWNCROFT BLVD
Practice Address - Street 2:SUITE 116
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14625-1435
Practice Address - Country:US
Practice Address - Phone:585-348-8858
Practice Address - Fax:585-267-7538
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-16
Last Update Date:2016-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3218111N00000X
NY012419111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
J00120148Medicare PIN