Provider Demographics
NPI:1710032461
Name:SIMMER CHIROPRACTIC
Entity Type:Organization
Organization Name:SIMMER CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMMER
Authorized Official - Suffix:
Authorized Official - Credentials:D C
Authorized Official - Phone:864-675-0616
Mailing Address - Street 1:PO BOX 309
Mailing Address - Street 2:
Mailing Address - City:PICKENS
Mailing Address - State:SC
Mailing Address - Zip Code:29671-0309
Mailing Address - Country:US
Mailing Address - Phone:864-850-1441
Mailing Address - Fax:864-850-1461
Practice Address - Street 1:1607 WOODRUFF RD
Practice Address - Street 2:STE 2
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-6910
Practice Address - Country:US
Practice Address - Phone:864-675-0616
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3188111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
U24144Medicare UPIN