Provider Demographics
NPI:1003238270
Name:KINYANJUI, PETER
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:
Last Name:KINYANJUI
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 1:13611 KING ST
Mailing Address - Street 2:APT 10212
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66221-8108
Mailing Address - Country:US
Mailing Address - Phone:913-709-4710
Mailing Address - Fax:
Practice Address - Street 1:13611 KING ST
Practice Address - Street 2:APT 10212
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66221-8108
Practice Address - Country:US
Practice Address - Phone:913-709-4710
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-07
Last Update Date:2014-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant