Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | D1315 | HI |
NPI | 1215094727 |
---|---|
Provider Name | Dr. Kevin Perrino |
First Address | Kailua Kona, HI 96740-1780 |
Second Address | Kailua Kona, HI 96740-1780 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/01/2007 |
Last Update Date | 30/04/2018 |