Provider Demographics
NPI:1073832200
Name:KEMPFERT, RACHEL WEST (DPT)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:WEST
Last Name:KEMPFERT
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 SHETTER AVE
Mailing Address - Street 2:APT. 9204
Mailing Address - City:JACKSONVILLE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32250-3455
Mailing Address - Country:US
Mailing Address - Phone:205-383-7751
Mailing Address - Fax:
Practice Address - Street 1:14785 OLD SAINT AUGUSTINE RD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32258-2496
Practice Address - Country:US
Practice Address - Phone:904-292-1808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-27
Last Update Date:2012-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 254772251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics