Healthcare Provider Details

I. General information

NPI: 1003816919
Provider Name (Legal Business Name): RANDY RALPH HINZE DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2005
Last Update Date: 09/25/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2421 23RD ST
COLUMBUS NE
68601-3305
US

IV. Provider business mailing address

2421 23RD ST
COLUMBUS NE
68601-3305
US

V. Phone/Fax

Practice location:
  • Phone: 402-564-9447
  • Fax: 402-564-7888
Mailing address:
  • Phone: 402-564-9447
  • Fax: 402-564-7888

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number651
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: