Provider Demographics
NPI:1902891922
Name:KEMPFER PROSTHETICS ORTHOTICS, INC
Entity Type:Organization
Organization Name:KEMPFER PROSTHETICS ORTHOTICS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:KEMPFER
Authorized Official - Suffix:
Authorized Official - Credentials:CP
Authorized Official - Phone:414-817-1452
Mailing Address - Street 1:4365 W LOOMIS RD
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53220-4147
Mailing Address - Country:US
Mailing Address - Phone:414-817-1452
Mailing Address - Fax:414-817-1461
Practice Address - Street 1:4365 W LOOMIS RD
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:WI
Practice Address - Zip Code:53220-4147
Practice Address - Country:US
Practice Address - Phone:414-817-1452
Practice Address - Fax:414-817-1461
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI41786600Medicaid
WI1261060001Medicare ID - Type UnspecifiedMEDICARE ID