Healthcare Provider Details

I. General information

NPI: 1629541412
Provider Name (Legal Business Name): JAMES DALE SCHOONOVER DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/04/2019
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6503 N BELT HWY
COUNTRY CLUB MO
64506-1048
US

IV. Provider business mailing address

6503 N BELT HWY
COUNTRY CLUB MO
64506-1048
US

V. Phone/Fax

Practice location:
  • Phone: 816-689-0671
  • Fax:
Mailing address:
  • Phone: 816-689-0671
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2018045543
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: