Provider Demographics
NPI:1649916214
Name:KEMP, LORI JO (PTA)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:JO
Last Name:KEMP
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:MRS
Other - First Name:LORI
Other - Middle Name:JO
Other - Last Name:KEMP
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PTA
Mailing Address - Street 1:360 HART DR
Mailing Address - Street 2:
Mailing Address - City:CRESCENT
Mailing Address - State:PA
Mailing Address - Zip Code:15046-4930
Mailing Address - Country:US
Mailing Address - Phone:412-320-1750
Mailing Address - Fax:
Practice Address - Street 1:234 CORAOPOLIS RD
Practice Address - Street 2:
Practice Address - City:CORAOPOLIS
Practice Address - State:PA
Practice Address - Zip Code:15108-4004
Practice Address - Country:US
Practice Address - Phone:412-331-6060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-06
Last Update Date:2022-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATE002344L225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant