Provider Demographics
NPI:1154388593
Name:KEMP, DOUGLAS (PT)
Entity type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:
Last Name:KEMP
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3103 PAPER MILL RD
Mailing Address - Street 2:
Mailing Address - City:WYOMISSING
Mailing Address - State:PA
Mailing Address - Zip Code:19610
Mailing Address - Country:US
Mailing Address - Phone:610-376-2100
Mailing Address - Fax:610-750-5806
Practice Address - Street 1:3103 PAPER MILL RD
Practice Address - Street 2:
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610
Practice Address - Country:US
Practice Address - Phone:610-376-2100
Practice Address - Fax:610-750-5806
Is Sole Proprietor?:No
Enumeration Date:2006-04-28
Last Update Date:2022-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT006957L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAP00065551OtherRAILROAD MEDICARE
PA50029021OtherCAPITAL BLUE CROSS
PA689967OtherHIGHMARK BLUE SHIELD
PA689967OtherHIGHMARK BLUE SHIELD