Provider Demographics
NPI:1568455608
Name:KEMPTON PHYSICAL THERAPY & SPORTS MEDICINE
Entity Type:Organization
Organization Name:KEMPTON PHYSICAL THERAPY & SPORTS MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:MARTIN
Authorized Official - Last Name:KEMPTON
Authorized Official - Suffix:
Authorized Official - Credentials:MPT ATC
Authorized Official - Phone:480-807-9000
Mailing Address - Street 1:6960 E BROADWAY RD
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85208-1916
Mailing Address - Country:US
Mailing Address - Phone:480-807-9000
Mailing Address - Fax:480-807-9234
Practice Address - Street 1:6960 E BROADWAY RD
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85208-1916
Practice Address - Country:US
Practice Address - Phone:480-807-9000
Practice Address - Fax:480-807-9234
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
Z69706Medicare ID - Type Unspecified