Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | KS |
NPI | 1003238270 |
---|---|
Provider Name | Peter Kinyanjui |
First Address | Overland Park, KS 66221-8108 |
Second Address | Overland Park, KS 66221-8108 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/01/2014 |
Last Update Date | 07/01/2014 |