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General NPI Number Information
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NPI Number | 1740711670
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Entity Type | Individual
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Provider Name | SEAN CHRISTOPHER WISCHHOVER D.C.
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Gender | Male
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Dates
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Enumeration Date | 03/22/2017
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Last Update Date | 03/22/2017
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Provider Practice Location Address
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Address Line | 4532 TAMIAMI TRL E
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City | NAPLES
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State | FL
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Zip | 34112-6713
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Country | US
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Telephone | 708-600-1529
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Fax |
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Provider Business Mailing Address
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Address Line | 7140 W PAULING RD
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City | MONEE
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State | IL
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Zip | 60449-9322
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Country | US
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Telephone | 708-600-1529
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH12120
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License Number State | FL
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