Provider Demographics
NPI:1679783641
Name:KEMP, DAVID W (ORT)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:W
Last Name:KEMP
Suffix:
Gender:M
Credentials:ORT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:309 CATALPA ST
Mailing Address - Street 2:
Mailing Address - City:DERBY
Mailing Address - State:KS
Mailing Address - Zip Code:67037-4203
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5111 E 21ST ST N
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67208-1606
Practice Address - Country:US
Practice Address - Phone:316-688-1888
Practice Address - Fax:316-688-5687
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2014-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS17-00170225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS0013435OtherOCCUPATIONAL THERAPIST