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General NPI Number Information
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NPI Number | 1861608846
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Entity Type | Individual
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Provider Name | SUSAN M SCHOONMAKER DC
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Gender | Female
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Dates
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Enumeration Date | 05/15/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 7032 US HWY 301 NORTH SIMPLE RELIEF WELLNESS CENTER
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City | ELLENTON
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State | FL
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Zip | 34222
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Country | US
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Telephone | 727-709-5636
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 5880
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City | CLEARWATER
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State | FL
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Zip | 33758
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Country | US
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Telephone | 727-709-5636
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH4255
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License Number State | FL
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