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Individual

RANDY LYNN SHERBON SR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1055 CLERMONT ST, DENVER, CO 80220-3808
(303) 393-4633
(303) 393-4685
Mailing address
1055 CLERMONT ST, DENVER, CO 80220
(303) 393-4633
(303) 393-4685

Taxonomy

Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
222Z00000X
ORTHOTIST
CO
01
225000000X
ORTHO PROSTH FITTER
CO
Enumeration date
12/02/2008
Last updated
12/02/2008
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