Provider Demographics
NPI:1316033848
Name:KEMP, RICHARD J (BS DC)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:J
Last Name:KEMP
Suffix:
Gender:M
Credentials:BS DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10855 WEST PARK PLACE
Mailing Address - Street 2:SUITE 9
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53224
Mailing Address - Country:US
Mailing Address - Phone:414-359-0300
Mailing Address - Fax:414-359-0303
Practice Address - Street 1:10855 WEST PARK PLACE
Practice Address - Street 2:SUITE 9
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53224
Practice Address - Country:US
Practice Address - Phone:414-359-0300
Practice Address - Fax:414-359-0303
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2007-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI0001845111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38788300Medicaid
WI391452273017OtherBCBS
WI391452273017OtherBCBS