Provider Demographics
NPI:1215094727
Name:PERRINO, KEVIN (DC)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:
Last Name:PERRINO
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 1:75-170 HUALALAI RD STE B104
Mailing Address - Street 2:
Mailing Address - City:KAILUA KONA
Mailing Address - State:HI
Mailing Address - Zip Code:96740-1780
Mailing Address - Country:US
Mailing Address - Phone:808-331-1454
Mailing Address - Fax:
Practice Address - Street 1:75-170 HUALALAI RD STE B104
Practice Address - Street 2:
Practice Address - City:KAILUA KONA
Practice Address - State:HI
Practice Address - Zip Code:96740-1780
Practice Address - Country:US
Practice Address - Phone:808-331-1454
Practice Address - Fax:808-331-1454
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2018-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HID1315111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJU73368Medicare UPIN
NJ022387Medicare ID - Type UnspecifiedMEDICARE PROVIDER ID #