MEDICARE: MR. BRAD JOHN KEMPTON MSPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	5494	AZ

General Provider Information

NPI Number	:	1558368217
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. BRAD JOHN KEMPTON MSPT

Provider Business Mailing Address
First Line	:	8495 S POWER RD
Second Line	:	STE 103
City	:	QUEEN CREEK
State	:	AZ
Zip	:	85242-6068
Country	:	US
Telephone Number	:	480-840-3564
Fax Number	:	480-840-3565

Provider Business Practice Location Address
First Line	:	8495 S POWER RD
Second Line	:	STE 103
City	:	QUEEN CREEK
State	:	AZ
Zip	:	85242-6068
Country	:	US
Telephone Number	:	480-840-3564
Fax Number	:	480-840-3565

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	11/28/2007

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