Provider Demographics
NPI:1508420381
Name:KEMP, DANIEL STEVEN (PT, DPT, CLT)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:STEVEN
Last Name:KEMP
Suffix:
Gender:M
Credentials:PT, DPT, CLT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:283 BUELL AVE
Mailing Address - Street 2:
Mailing Address - City:WATERVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13480-1527
Mailing Address - Country:US
Mailing Address - Phone:315-534-4405
Mailing Address - Fax:315-338-7417
Practice Address - Street 1:1500 N JAMES ST
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:NY
Practice Address - Zip Code:13440-2844
Practice Address - Country:US
Practice Address - Phone:315-338-7154
Practice Address - Fax:315-338-7417
Is Sole Proprietor?:No
Enumeration Date:2019-04-26
Last Update Date:2019-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY042156-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist