Provider Demographics
NPI:1215202007
Name:PINGEL, ABBY N (PTA)
Entity Type:Individual
Prefix:
First Name:ABBY
Middle Name:N
Last Name:PINGEL
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:422 11TH AVE W
Mailing Address - Street 2:
Mailing Address - City:SPENCER
Mailing Address - State:IA
Mailing Address - Zip Code:51301-3041
Mailing Address - Country:US
Mailing Address - Phone:712-363-2220
Mailing Address - Fax:
Practice Address - Street 1:1120 WALNUT ST
Practice Address - Street 2:
Practice Address - City:NORTH BEND
Practice Address - State:NE
Practice Address - Zip Code:68649-5012
Practice Address - Country:US
Practice Address - Phone:402-216-0315
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-13
Last Update Date:2012-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1083225200000X
IA004853225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant