Individual
KIP D CHESMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.P.T.
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
0821
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0763219
—
IA
01
—
31824
BCBS IOWA
IA
05
—
421480644-34
—
NE
01
—
4993432
BCBS SOUTH DAKOTA
SD
05
—
5833242
—
SD
Enumeration date
03/24/2006
Last updated
06/21/2013
Update your record
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