Provider Demographics
NPI:1912366964
Name:SCHOONOVER, RIKKI
Entity Type:Individual
Prefix:
First Name:RIKKI
Middle Name:
Last Name:SCHOONOVER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:RIKKI
Other - Middle Name:
Other - Last Name:KLEMM, CARAWAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4605 DEER RIDGE BLVD
Mailing Address - Street 2:
Mailing Address - City:YUKON
Mailing Address - State:OK
Mailing Address - Zip Code:73099-2324
Mailing Address - Country:US
Mailing Address - Phone:405-669-1578
Mailing Address - Fax:
Practice Address - Street 1:3801 N COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:BETHANY
Practice Address - State:OK
Practice Address - Zip Code:73008-3341
Practice Address - Country:US
Practice Address - Phone:405-669-1578
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-18
Last Update Date:2016-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist