Provider Demographics
NPI:1699553925
Name:SCHNAUTZ, BONITA SUE (ND)
Entity type:Individual
Prefix:
First Name:BONITA
Middle Name:SUE
Last Name:SCHNAUTZ
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 OLYMPIC CLUB DR
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29483-5194
Mailing Address - Country:US
Mailing Address - Phone:812-453-8457
Mailing Address - Fax:
Practice Address - Street 1:212 OLYMPIC CLUB DR
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29483-5194
Practice Address - Country:US
Practice Address - Phone:812-453-8457
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-18
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN175L00000X
174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator
No175L00000XOther Service ProvidersHomeopath