Individual
PETER KIONGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MHS,OTR
Contact information
Practice address
101 N 7TH ST, #16 ROOM 102, MAYFIELD, KY 42066-1801
(270) 727-1023
(270) 247-6669
Mailing address
1362 W BROADWAY ST, MAYFIELD, KY 42066-1930
(270) 727-1023
(270) 247-6669
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1718
FIRST STEPS PROGRAM
KY
Enumeration date
04/26/2007
Last updated
07/08/2008
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