Provider Demographics
NPI:1730693169
Name:HUMPAL, MICHAEL J (DC)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:J
Last Name:HUMPAL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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 1:1295 JORDAN ST STE 6B
Practice Address - Street 2:
Practice Address - City:NORTH LIBERTY
Practice Address - State:IA
Practice Address - Zip Code:52317-8020
Practice Address - Country:US
Practice Address - Phone:319-430-7892
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-21
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA089285111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor