Provider Demographics
NPI:1487780433
Name:JOCHUM, CRAIG CARL (APRN, DC, DACBN)
Entity type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:CARL
Last Name:JOCHUM
Suffix:
Gender:M
Credentials:APRN, DC, DACBN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:676 SE MONTEREY RD
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994-4410
Mailing Address - Country:US
Mailing Address - Phone:561-686-0120
Mailing Address - Fax:561-686-8073
Practice Address - Street 1:676 SE MONTEREY RD
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-4410
Practice Address - Country:US
Practice Address - Phone:561-686-0120
Practice Address - Fax:561-686-8073
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2020-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH9098111NN1001X, 111N00000X, 208D00000X
FLAPRN11005504208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No111NN1001XChiropractic ProvidersChiropractorNutrition
No111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLCH9098OtherCHIROPRACTOR
FLAPRN11005504OtherNURSE PRACTITIONER