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NPI Code Detail

MEDICARE: KRYSTLE N KEMPEN PT

MEDICARE: KRYSTLE N KEMPEN PT
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
1225100000XPhysical Therapist11694-24WI

General Provider Information

NPI Number : 1932490729
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRYSTLE N KEMPEN PT
Provider Business Mailing Address
First Line : 2615 N DOWNER AVE
Second Line :
City : MILWAUKEE
State : WI
Zip : 53211-4245
Country : US
Telephone Number : 414-962-4400
Fax Number : 414-962-5674
Provider Business Practice Location Address
First Line : 2615 N DOWNER AVE
Second Line :
City : MILWAUKEE
State : WI
Zip : 53211-4245
Country : US
Telephone Number : 414-962-4400
Fax Number : 414-962-5674
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/27/2011
Last Update Date : 07/10/2013

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Directions to “ KRYSTLE N KEMPEN PT” Practice Location

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