Healthcare Provider Details

I. General information

NPI: 1104990746
Provider Name (Legal Business Name): CHRISTINE L. HOCH ENTERPRISES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/17/2006
Last Update Date: 06/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11078 ESTEBAN DR
FORT MYERS FL
33912-8962
US

IV. Provider business mailing address

11078 ESTEBAN DR
FORT MYERS FL
33912-8962
US

V. Phone/Fax

Practice location:
  • Phone: 708-267-9600
  • Fax:
Mailing address:
  • Phone: 708-227-9600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number038007516
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number209007916
License Number StateIL

VIII. Authorized Official

Name: DR. CHRISTINE L HOCH
Title or Position: PRESIDENT
Credential: DC
Phone: 708-267-9600