Healthcare Provider Details

I. General information

NPI: 1679162291
Provider Name (Legal Business Name): SAMANTHA KAY KEMMER DC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/18/2021
Last Update Date: 04/11/2026
Certification Date: 04/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1125 N BROADWAY
MINOT ND
58703-1323
US

IV. Provider business mailing address

1125 N BROADWAY
MINOT ND
58703-1323
US

V. Phone/Fax

Practice location:
  • Phone: 701-852-8193
  • Fax: 844-500-1567
Mailing address:
  • Phone: 254-931-5895
  • Fax: 844-500-1567

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1137
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: