Provider Demographics
NPI:1992219323
Name:HUMPAL CHIROPRACTIC, LLC
Entity type:Organization
Organization Name:HUMPAL CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:HUMPAL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:319-430-7892
Mailing Address - Street 1:1210 JORDAN ST STE 2A
Mailing Address - Street 2:
Mailing Address - City:NORTH LIBERTY
Mailing Address - State:IA
Mailing Address - Zip Code:52317-8031
Mailing Address - Country:US
Mailing Address - Phone:319-325-3558
Mailing Address - Fax:888-429-0451
Practice Address - Street 1:1210 JORDAN ST STE 2A
Practice Address - Street 2:
Practice Address - City:NORTH LIBERTY
Practice Address - State:IA
Practice Address - Zip Code:52317-8031
Practice Address - Country:US
Practice Address - Phone:319-325-3558
Practice Address - Fax:888-429-0451
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-21
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA089285261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service