Individual
NICOLE HUMPF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
310 TAUGHANNOCK BLVD, ITHACA, NY 14850-3251
(607) 252-3580
Mailing address
105A KAY ST, ITHACA, NY 14850-1703
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
002117
NY
Other
Enumeration date
11/02/2017
Last updated
11/02/2017
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