Healthcare Provider Details
I. General information
NPI: 1891875290
Provider Name (Legal Business Name): KEMP CHIROPRACTIC, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/17/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1044 N ESKEW RD
BOONVILLE IN
47601-7707
US
IV. Provider business mailing address
1044 N ESKEW RD
BOONVILLE IN
47601-7707
US
V. Phone/Fax
- Phone: 812-897-1700
- Fax: 812-897-0071
- Phone: 812-897-1700
- Fax: 812-897-0071
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | 08002171A |
| License Number State | IN |
VIII. Authorized Official
Name: DR.
THOMAS
WESLEY
KEMP
Title or Position: PRESIDENT
Credential: D.C.
Phone: 812-897-1700