Provider Demographics
NPI:1992741276
Name:KRUMMEL, GERALD ALAN (ATC)
Entity type:Individual
Prefix:MR
First Name:GERALD
Middle Name:ALAN
Last Name:KRUMMEL
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:MR
Other - First Name:JERRY
Other - Middle Name:
Other - Last Name:KRUMMEL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ATC
Mailing Address - Street 1:2519 11TH AVE UNIT A311
Mailing Address - Street 2:
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80631-7100
Mailing Address - Country:US
Mailing Address - Phone:503-936-6987
Mailing Address - Fax:
Practice Address - Street 1:2519 11TH AVE UNIT A311
Practice Address - Street 2:
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80631-7100
Practice Address - Country:US
Practice Address - Phone:503-936-6987
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2019-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer