Provider Demographics
NPI:1326068297
Name:KEMLAGE, ROBERT ANDREW (DC)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:ANDREW
Last Name:KEMLAGE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10404 W COGGINS DR
Mailing Address - Street 2:SUITE 114
Mailing Address - City:SUN CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:85351-3437
Mailing Address - Country:US
Mailing Address - Phone:623-972-2258
Mailing Address - Fax:623-875-8020
Practice Address - Street 1:10404 W COGGINS DR
Practice Address - Street 2:SUITE 114
Practice Address - City:SUN CITY
Practice Address - State:AZ
Practice Address - Zip Code:85351-3437
Practice Address - Country:US
Practice Address - Phone:623-972-2258
Practice Address - Fax:623-875-8020
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2007-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5445111N00000X
CO3551111N00000X
NJ38MC00536800111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ29322Medicare ID - Type UnspecifiedPROVIDER NUMBER