Provider Demographics
NPI:1427239771
Name:KEMPTON AND KEMPTON PHYSICAL THERAPY AND SPORTS REHABILITATION LLC
Entity type:Organization
Organization Name:KEMPTON AND KEMPTON PHYSICAL THERAPY AND SPORTS REHABILITATION LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRAD
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:KEMPTON
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT
Authorized Official - Phone:480-840-3564
Mailing Address - Street 1:8495 S POWER RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:QUEEN CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85142-6068
Mailing Address - Country:US
Mailing Address - Phone:480-840-3564
Mailing Address - Fax:480-840-3565
Practice Address - Street 1:8495 S POWER RD STE 103
Practice Address - Street 2:
Practice Address - City:QUEEN CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85142-6068
Practice Address - Country:US
Practice Address - Phone:480-840-3564
Practice Address - Fax:480-840-3565
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-15
Last Update Date:2011-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5494261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ646002Medicaid
AZ646002Medicaid