Provider Demographics
NPI:1154907558
Name:KEMPER PELVIC PHYSIOTHERAPY
Entity type:Organization
Organization Name:KEMPER PELVIC PHYSIOTHERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:KEMPER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:404-606-2730
Mailing Address - Street 1:517 CLAIREMONT AVE
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30030-1835
Mailing Address - Country:US
Mailing Address - Phone:404-606-2730
Mailing Address - Fax:470-777-2716
Practice Address - Street 1:1549 CLAIRMONT RD STE 105
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033-4636
Practice Address - Country:US
Practice Address - Phone:404-606-2730
Practice Address - Fax:470-777-2716
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-24
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty