Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | PT 25477 | FL |
NPI | 1073832200 |
---|---|
Provider Name | Rachel West Kempfert |
First Address | Jacksonville Beach, FL 32250-3455 |
Second Address | Jacksonville, FL 32258-2496 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/05/2010 |
Last Update Date | 16/08/2012 |