Provider Demographics
NPI:1629109749
Name:HUMPAL, RONDA A (ATC)
Entity Type:Individual
Prefix:
First Name:RONDA
Middle Name:A
Last Name:HUMPAL
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2885 SPRINGREEN DR
Mailing Address - Street 2:#2
Mailing Address - City:ASBURY
Mailing Address - State:IA
Mailing Address - Zip Code:52002-2439
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2885 SPRINGREEN DR
Practice Address - Street 2:#2
Practice Address - City:ASBURY
Practice Address - State:IA
Practice Address - Zip Code:52002-2439
Practice Address - Country:US
Practice Address - Phone:563-588-2445
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer