Individual
KENNETH PEISECKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OT
Contact information
Practice address
64 DANBURY RD, WILTON, CT 06897-4429
(203) 800-0332
(800) 970-5001
Mailing address
6802 CHATEAU CHASE DR, COLUMBUS, OH 43235-3940
(614) 352-4680
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OC011370
PA
Other
Enumeration date
06/21/2010
Last updated
06/21/2010
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