Provider Demographics
NPI:1558368217
Name:KEMPTON, BRAD JOHN (MSPT)
Entity Type:Individual
Prefix:MR
First Name:BRAD
Middle Name:JOHN
Last Name:KEMPTON
Suffix:
Gender:M
Credentials:MSPT
Other - Prefix:
Other - First Name:BRAD
Other - Middle Name:J
Other - Last Name:KEMPTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSPT
Mailing Address - Street 1:8495 S POWER RD
Mailing Address - Street 2:STE 103
Mailing Address - City:QUEEN CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85242-6068
Mailing Address - Country:US
Mailing Address - Phone:480-840-3564
Mailing Address - Fax:480-840-3565
Practice Address - Street 1:8495 S POWER RD
Practice Address - Street 2:STE 103
Practice Address - City:QUEEN CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85242-6068
Practice Address - Country:US
Practice Address - Phone:480-840-3564
Practice Address - Fax:480-840-3565
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2007-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5494225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ83136Medicare PIN
AZQ25316Medicare UPIN