Provider Demographics
NPI:1770068025
Name:KEMPEN, THOMAS MAXIMILLIAN
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:MAXIMILLIAN
Last Name:KEMPEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 VALLEYVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:ALIQUIPPA
Mailing Address - State:PA
Mailing Address - Zip Code:15001-4735
Mailing Address - Country:US
Mailing Address - Phone:724-888-2548
Mailing Address - Fax:724-888-2913
Practice Address - Street 1:3399 BRODHEAD RD STE A
Practice Address - Street 2:
Practice Address - City:ALIQUIPPA
Practice Address - State:PA
Practice Address - Zip Code:15001-1290
Practice Address - Country:US
Practice Address - Phone:724-888-2548
Practice Address - Fax:724-888-2913
Is Sole Proprietor?:No
Enumeration Date:2018-10-02
Last Update Date:2018-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC014616225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist