Provider Demographics
NPI:1528492576
Name:KEMPLE, ADAM (PTA)
Entity type:Individual
Prefix:MR
First Name:ADAM
Middle Name:
Last Name:KEMPLE
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:188 THORNTON RD
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:IN
Mailing Address - Zip Code:47243-9714
Mailing Address - Country:US
Mailing Address - Phone:812-866-8396
Mailing Address - Fax:
Practice Address - Street 1:188 THORNTON RD
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:IN
Practice Address - Zip Code:47243-9714
Practice Address - Country:US
Practice Address - Phone:812-886-8396
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-27
Last Update Date:2013-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN06004689A225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant