Provider Demographics
NPI:1750913570
Name:SCHMIERER, CORRINA MICHELLE
Entity type:Individual
Prefix:
First Name:CORRINA
Middle Name:MICHELLE
Last Name:SCHMIERER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1157 MAIN ST # 1157
Mailing Address - Street 2:
Mailing Address - City:PORTERDALE
Mailing Address - State:GA
Mailing Address - Zip Code:30014-3440
Mailing Address - Country:US
Mailing Address - Phone:678-372-8859
Mailing Address - Fax:
Practice Address - Street 1:1157 MAIN ST # 1157
Practice Address - Street 2:
Practice Address - City:PORTERDALE
Practice Address - State:GA
Practice Address - Zip Code:30014-3440
Practice Address - Country:US
Practice Address - Phone:678-372-8859
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-10
Last Update Date:2020-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer