Provider Demographics
NPI:1326550369
Name:PERRINE, CHRISTOPHER BRYAN (LAT, ATC)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:BRYAN
Last Name:PERRINE
Suffix:
Gender:M
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:970 HUNTERS RUN DR
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89002-9693
Mailing Address - Country:US
Mailing Address - Phone:702-767-2939
Mailing Address - Fax:
Practice Address - Street 1:970 HUNTERS RUN DR
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89002-9693
Practice Address - Country:US
Practice Address - Phone:702-767-2939
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-31
Last Update Date:2017-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV05063772255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer