Provider Demographics
NPI:1194374868
Name:ROMPORTL, ALLISON (DC)
Entity Type:Individual
Prefix:DR
First Name:ALLISON
Middle Name:
Last Name:ROMPORTL
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:ALLISON
Other - Middle Name:
Other - Last Name:NORTON ROMPORTL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:2669 SPRUCE ST
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80302-3808
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2669 SPRUCE ST
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80302-3808
Practice Address - Country:US
Practice Address - Phone:303-901-9798
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-05
Last Update Date:2019-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0007777111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor