Provider Demographics
NPI:1629041272
Name:BOCHICCHIO, SHEILA A (DC)
Entity Type:Individual
Prefix:DR
First Name:SHEILA
Middle Name:A
Last Name:BOCHICCHIO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1685
Mailing Address - Street 2:
Mailing Address - City:WEAVERVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28787-1685
Mailing Address - Country:US
Mailing Address - Phone:828-658-3003
Mailing Address - Fax:
Practice Address - Street 1:289 MERRIMON AVE
Practice Address - Street 2:
Practice Address - City:WEAVERVILLE
Practice Address - State:NC
Practice Address - Zip Code:28787-9252
Practice Address - Country:US
Practice Address - Phone:828-658-3003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2008-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1554111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC562130124OtherTAX ID
NC8908208Medicaid
NC8908208Medicaid
NC562130124OtherTAX ID