Healthcare Provider Details

I. General information

NPI: 1720310014
Provider Name (Legal Business Name): ELIZABETH SCHOENEKASE DC, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/11/2010
Last Update Date: 02/11/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 COLLINS DR
FESTUS MO
63028-2077
US

IV. Provider business mailing address

PO BOX 96
FESTUS MO
63028-0096
US

V. Phone/Fax

Practice location:
  • Phone: 636-937-9200
  • Fax: 636-937-0900
Mailing address:
  • Phone: 636-937-9200
  • Fax: 636-937-0900

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2008011494
License Number StateMO

VIII. Authorized Official

Name: DR. ELIZABETH E SCHOENEKASE
Title or Position: OWNER/PRESIDENT
Credential: DC
Phone: 636-937-9200