Organization
DR. RANDY L. HERTNEKY
Active
Parent organization
DR. RANDY L. HERTNEKY
Organization subpart
Yes
Provider details
NPI number
Legal business name
DR. RANDY L. HERTNEKY
Authorized official
DR. RANDY L. HERTNEKY O.D. (OWNER)
(970) 848-5345
Entity
Organization
Contact information
Practice address
105 S MAIN ST, YUMA, CO 80759-1913
(970) 848-5345
(970) 848-5346
Mailing address
105 S MAIN ST, YUMA, CO 80759-1913
(970) 848-5345
(970) 848-5346
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08010928
—
CO
Enumeration date
01/31/2008
Last updated
01/31/2008
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