Healthcare Provider Details

I. General information

NPI: 1447384995
Provider Name (Legal Business Name): CRISTIAN D MIHOC ND, LAC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/15/2007
Last Update Date: 09/04/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 INDIA ST FLOOR 3
BOSTON MA
02110-3500
US

IV. Provider business mailing address

59 COBURN TER APT. 11
EVERETT MA
02149-4033
US

V. Phone/Fax

Practice location:
  • Phone: 617-818-6189
  • Fax: 617-818-6189
Mailing address:
  • Phone: 617-818-6189
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number221007
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number099-0000092
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: