Provider Demographics
NPI:1447384995
Name:MIHOC, CRISTIAN D (ND, LAC)
Entity Type:Individual
Prefix:
First Name:CRISTIAN
Middle Name:D
Last Name:MIHOC
Suffix:
Gender:M
Credentials:ND, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:59 COBURN TER
Mailing Address - Street 2:APT. 11
Mailing Address - City:EVERETT
Mailing Address - State:MA
Mailing Address - Zip Code:02149-4033
Mailing Address - Country:US
Mailing Address - Phone:617-818-6189
Mailing Address - Fax:
Practice Address - Street 1:35 INDIA ST
Practice Address - Street 2:FLOOR 3
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02110-3500
Practice Address - Country:US
Practice Address - Phone:617-818-6189
Practice Address - Fax:617-818-6189
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2014-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA221007171100000X
VT099-0000092175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No171100000XOther Service ProvidersAcupuncturist