Provider Demographics
NPI:1073557427
Name:PERINOVIC, JOSEPH J (DC)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:J
Last Name:PERINOVIC
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 1:1151 STONE DR
Mailing Address - Street 2:SUITE B2
Mailing Address - City:HARRISON
Mailing Address - State:OH
Mailing Address - Zip Code:45030-2778
Mailing Address - Country:US
Mailing Address - Phone:513-367-4127
Mailing Address - Fax:513-367-4127
Practice Address - Street 1:1150 HARRISON AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:HARRISON
Practice Address - State:OH
Practice Address - Zip Code:45030-2503
Practice Address - Country:US
Practice Address - Phone:513-367-4127
Practice Address - Fax:513-367-4127
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2007-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1239111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0648946Medicaid
OHPE0594552Medicare PIN
OH0648946Medicaid