Provider Demographics
NPI:1205452992
Name:VOGRIN, PETER J (DPT)
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:J
Last Name:VOGRIN
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1253 MAKALAPA RD
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817
Mailing Address - Country:US
Mailing Address - Phone:886-383-2778
Mailing Address - Fax:
Practice Address - Street 1:1253 MAKALAPA RD
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:97618
Practice Address - Country:US
Practice Address - Phone:888-638-2778
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-18
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
CO0017050225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist