Provider Demographics
NPI:1497443774
Name:PERKINS, ANTIONE FRANKLIN
Entity Type:Individual
Prefix:
First Name:ANTIONE
Middle Name:FRANKLIN
Last Name:PERKINS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:366 RESERVATION RD APT A7
Mailing Address - Street 2:
Mailing Address - City:MARINA
Mailing Address - State:CA
Mailing Address - Zip Code:93933-3266
Mailing Address - Country:US
Mailing Address - Phone:424-249-0054
Mailing Address - Fax:
Practice Address - Street 1:366 RESERVATION RD APT A7
Practice Address - Street 2:
Practice Address - City:MARINA
Practice Address - State:CA
Practice Address - Zip Code:93933-3266
Practice Address - Country:US
Practice Address - Phone:424-240-0054
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-25
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other