Provider Demographics
NPI:1427725357
Name:KEMPER, CANDACE CAPELAN (PT)
Entity type:Individual
Prefix:
First Name:CANDACE
Middle Name:CAPELAN
Last Name:KEMPER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2226 MURPHY ST
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71103-2549
Mailing Address - Country:US
Mailing Address - Phone:318-422-4187
Mailing Address - Fax:318-603-6953
Practice Address - Street 1:9900 SMITHERMAN DR
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71115-2923
Practice Address - Country:US
Practice Address - Phone:318-797-2240
Practice Address - Fax:318-364-5193
Is Sole Proprietor?:No
Enumeration Date:2021-08-27
Last Update Date:2021-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist