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Individual
RANDY THOR HERMANS
Active
Individual
RANDY THOR HERMANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT00007350
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5137660
AETNA
WA
01
—
HE2236
REGENCE BLUE SHIELD
WA
Enumeration date
09/14/2006
Last updated
06/28/2012
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