Individual
MR. RANDY JACOB HERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
111 VETERANS BLVD, SUITE 470, METAIRIE, LA 70005
(504) 834-9259
Mailing address
1508 FRANCIS AVE, METAIRIE, LA 70003-4648
(504) 885-9838
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05029
LA
Other
Enumeration date
02/21/2007
Last updated
07/08/2007
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