MEDICARE: DR. KEVIN PERRINO D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111NS0005X	Sports Physician Chiropractor	D1315	HI

General Provider Information

NPI Number	:	1215094727
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KEVIN PERRINO D.C.

Provider Business Mailing Address
First Line	:	75-170 HUALALAI RD STE B104
Second Line	:
City	:	KAILUA KONA
State	:	HI
Zip	:	96740-1780
Country	:	US
Telephone Number	:	808-331-1454
Fax Number	:

Provider Business Practice Location Address
First Line	:	75-170 HUALALAI RD STE B104
Second Line	:
City	:	KAILUA KONA
State	:	HI
Zip	:	96740-1780
Country	:	US
Telephone Number	:	808-331-1454
Fax Number	:	808-331-1454

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/03/2007
Last Update Date	:	04/30/2018

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