Provider Demographics
NPI:1366148587
Name:GIESING, PAYTON PHILLIP
Entity type:Individual
Prefix:MR
First Name:PAYTON
Middle Name:PHILLIP
Last Name:GIESING
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 1:383 POINT RETURN DR # A
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:MO
Mailing Address - Zip Code:63021-5715
Mailing Address - Country:US
Mailing Address - Phone:217-577-9477
Mailing Address - Fax:
Practice Address - Street 1:383 POINT RETURN DR # A
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:MO
Practice Address - Zip Code:63021-5715
Practice Address - Country:US
Practice Address - Phone:217-577-9477
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-31
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist