Provider Demographics
NPI:1457734055
Name:KEMPPAINEN, CHRISTAL MARIE (LMT)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTAL
Middle Name:MARIE
Last Name:KEMPPAINEN
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:MS
Other - First Name:CHRISTAL
Other - Middle Name:MARIE
Other - Last Name:ERIKAINEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MT
Mailing Address - Street 1:11491 N LAIRD RD
Mailing Address - Street 2:
Mailing Address - City:PELKIE
Mailing Address - State:MI
Mailing Address - Zip Code:49958-9222
Mailing Address - Country:US
Mailing Address - Phone:906-338-2992
Mailing Address - Fax:
Practice Address - Street 1:11491 N LAIRD RD
Practice Address - Street 2:
Practice Address - City:PELKIE
Practice Address - State:MI
Practice Address - Zip Code:49958-9222
Practice Address - Country:US
Practice Address - Phone:906-338-2992
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-01
Last Update Date:2015-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7501002906225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist