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Individual

JEFFREY ALAN KEMP

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MS, PT

Contact information

Practice address
315 E SAN MARNAN DR, WATERLOO, IA 50702-5837
(319) 239-5009
Mailing address
315 E SAN MARNAN DR, WATERLOO, IA 50702-5837
(319) 239-5009

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
02099
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0274241
IA
01
421493296-01
JOHN DEERE PROVIDER ID
IA
01
45190
BLUE CROSS BLUE SHIELD ID
IA
Enumeration date
07/18/2005
Last updated
03/23/2012
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