Individual
LUIS FERNANDO HERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
128 MARKET ST, ALAMOSA, CO 81101-2290
(719) 589-5161
Mailing address
211 EDISON AVE, ALAMOSA, CO 81101-2531
(208) 316-6272
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0003766
CO
Other
Enumeration date
08/21/2013
Last updated
08/21/2013
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