Provider Demographics
NPI:1619326360
Name:CHIO-KEMP, MIMI QUIRANTE X (BSPT)
Entity Type:Individual
Prefix:MRS
First Name:MIMI
Middle Name:QUIRANTE
Last Name:CHIO-KEMP
Suffix:X
Gender:F
Credentials:BSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 EASTMAN RD
Mailing Address - Street 2:
Mailing Address - City:LACONIA
Mailing Address - State:NH
Mailing Address - Zip Code:03246-1412
Mailing Address - Country:US
Mailing Address - Phone:603-520-4631
Mailing Address - Fax:603-279-7808
Practice Address - Street 1:238 DANIEL WEBSTER HWY
Practice Address - Street 2:
Practice Address - City:MEREDITH
Practice Address - State:NH
Practice Address - Zip Code:03253-5803
Practice Address - Country:US
Practice Address - Phone:603-279-7208
Practice Address - Fax:603-279-7808
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-03
Last Update Date:2016-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2005225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist