Provider Demographics
NPI:1932490729
Name:KEMPEN, KRYSTLE N (PT)
Entity Type:Individual
Prefix:
First Name:KRYSTLE
Middle Name:N
Last Name:KEMPEN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2615 N DOWNER AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53211-4245
Mailing Address - Country:US
Mailing Address - Phone:414-962-4400
Mailing Address - Fax:414-962-5674
Practice Address - Street 1:2615 N DOWNER AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53211-4245
Practice Address - Country:US
Practice Address - Phone:414-962-4400
Practice Address - Fax:414-962-5674
Is Sole Proprietor?:No
Enumeration Date:2011-04-27
Last Update Date:2013-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI11694-24225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist