Provider Demographics
NPI:1356406441
Name:SCHWINGLE, BRYAN TIMOTHY (DC)
Entity type:Individual
Prefix:DR
First Name:BRYAN
Middle Name:TIMOTHY
Last Name:SCHWINGLE
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 1:100 WHITE SPRUCE BLVD
Mailing Address - Street 2:SUITE L205
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14623-1507
Mailing Address - Country:US
Mailing Address - Phone:585-305-5191
Mailing Address - Fax:
Practice Address - Street 1:100 WHITE SPRUCE BLVD
Practice Address - Street 2:SUITE L205
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14623-1507
Practice Address - Country:US
Practice Address - Phone:585-305-5191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX010963111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYV02222Medicare UPIN
NYIA0621Medicare ID - Type Unspecified