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NPI Code Detail

MEDICARE: ABBY N PINGEL PTA

MEDICARE: ABBY N PINGEL PTA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225200000XPhysical Therapy Assistant1083NE
2225200000XPhysical Therapy Assistant004853IA

General Provider Information

NPI Number : 1215202007
Entity Type Code : Individual
Provider Name (Legal Business Name) : ABBY N PINGEL PTA
Provider Business Mailing Address
First Line : 422 11TH AVE W
Second Line :
City : SPENCER
State : IA
Zip : 51301-3041
Country : US
Telephone Number : 712-363-2220
Fax Number :
Provider Business Practice Location Address
First Line : 1120 WALNUT ST
Second Line :
City : NORTH BEND
State : NE
Zip : 68649-5012
Country : US
Telephone Number : 402-216-0315
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/13/2012
Last Update Date : 05/10/2012

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