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Individual

DR. RANDY L HERTNEKY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
415 MAIN ST, WRAY, CO 80758-1724
(970) 332-4823
(970) 848-5346
Mailing address
415 MAIN ST, WRAY, CO 80758-1724
(970) 332-4823
(970) 848-5346

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1092
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
08010928
CO
Enumeration date
12/27/2005
Last updated
06/28/2021
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