Provider Demographics
NPI:1275583593
Name:KEMP, BRIANNE LEA (DC)
Entity Type:Individual
Prefix:DR
First Name:BRIANNE
Middle Name:LEA
Last Name:KEMP
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 WEXFORD BAYNE RD
Mailing Address - Street 2:
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090-8748
Mailing Address - Country:US
Mailing Address - Phone:724-940-3900
Mailing Address - Fax:
Practice Address - Street 1:141 WEXFORD BAYNE RD
Practice Address - Street 2:
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-8748
Practice Address - Country:US
Practice Address - Phone:724-940-3900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2015-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC009592111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1015367320001Medicaid