Provider Demographics
NPI:1265094007
Name:KID POWER, LLC
Entity type:Organization
Organization Name:KID POWER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KACY
Authorized Official - Middle Name:
Authorized Official - Last Name:PUNTILLO
Authorized Official - Suffix:
Authorized Official - Credentials:OTD, MS, OTR/L
Authorized Official - Phone:262-496-0289
Mailing Address - Street 1:6125 GREEN BAY RD STE 800
Mailing Address - Street 2:
Mailing Address - City:KENOSHA
Mailing Address - State:WI
Mailing Address - Zip Code:53142-2982
Mailing Address - Country:US
Mailing Address - Phone:262-496-0289
Mailing Address - Fax:
Practice Address - Street 1:6125 GREEN BAY RD STE 800
Practice Address - Street 2:
Practice Address - City:KENOSHA
Practice Address - State:WI
Practice Address - Zip Code:53142-2982
Practice Address - Country:US
Practice Address - Phone:262-496-0289
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-02
Last Update Date:2025-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Single Specialty