Provider Demographics
NPI:1861608846
Name:SCHOONMAKER, SUSAN M (DC)
Entity type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:M
Last Name:SCHOONMAKER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5880
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33758
Mailing Address - Country:US
Mailing Address - Phone:727-709-5636
Mailing Address - Fax:
Practice Address - Street 1:7032 US HWY 301 NORTH
Practice Address - Street 2:SIMPLE RELIEF WELLNESS CENTER
Practice Address - City:ELLENTON
Practice Address - State:FL
Practice Address - Zip Code:34222
Practice Address - Country:US
Practice Address - Phone:727-709-5636
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH4255111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor