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Individual

DANIELLE SCHOENBACHER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MS, ATC, LATC, PES

Contact information

Practice address
600 SMILEY ST, O'FALLON, IL 62269
(618) 318-6847
Mailing address
PO BOX 52, TAMAROA, IL 62888-0052
(618) 318-6847

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2000030838
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
S512-1619-5652
DRIVER'S LICENSE
IL
Enumeration date
07/14/2022
Last updated
07/14/2022
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