MEDICARE: MISS JENNIFER M. SCHUMMER L.M.T.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	172M00000X	Mechanotherapist	015094	NY

General Provider Information

NPI Number	:	1962690123
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS JENNIFER M. SCHUMMER L.M.T.

Provider Business Mailing Address
First Line	:	5353 MAIN ST
Second Line	:
City	:	WILLIAMSVILLE
State	:	NY
Zip	:	14221-5337
Country	:	US
Telephone Number	:	716-725-4218
Fax Number	:	716-662-9370

Provider Business Practice Location Address
First Line	:	5353 MAIN ST
Second Line	:
City	:	WILLIAMSVILLE
State	:	NY
Zip	:	14221-5337
Country	:	US
Telephone Number	:	716-725-4218
Fax Number	:	716-662-9370

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/11/2007
Last Update Date	:	10/11/2007

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