Provider Demographics
NPI:1750383444
Name:BOCCHINO, CHRISTOPHER VINCENT (DC)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:VINCENT
Last Name:BOCCHINO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:729 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:EASLEY
Mailing Address - State:SC
Mailing Address - Zip Code:29640-3153
Mailing Address - Country:US
Mailing Address - Phone:864-855-1515
Mailing Address - Fax:864-855-9595
Practice Address - Street 1:729 E MAIN ST
Practice Address - Street 2:
Practice Address - City:EASLEY
Practice Address - State:SC
Practice Address - Zip Code:29640-3153
Practice Address - Country:US
Practice Address - Phone:864-855-1515
Practice Address - Fax:864-855-9595
Is Sole Proprietor?:No
Enumeration Date:2005-08-11
Last Update Date:2008-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2465111N00000X
SC2162111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC8908656Medicaid
SC8908656Medicaid
SC8814Medicare PIN