Provider Demographics
NPI:1477096113
Name:PINTO, KIRKWOOD TAKESHI (OTR/L)
Entity Type:Individual
Prefix:
First Name:KIRKWOOD
Middle Name:TAKESHI
Last Name:PINTO
Suffix:
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:KIRK
Other - Middle Name:
Other - Last Name:PINTO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OTR/L
Mailing Address - Street 1:2100 NW BARRY RD
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64154-1000
Mailing Address - Country:US
Mailing Address - Phone:816-521-6610
Mailing Address - Fax:
Practice Address - Street 1:2100 NW BARRY RD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64154-1000
Practice Address - Country:US
Practice Address - Phone:816-521-6610
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-29
Last Update Date:2019-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2016023885225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist