Provider Demographics
NPI:1558440339
Name:POMAJZL, RANDY LYNN (DC)
Entity Type:Individual
Prefix:DR
First Name:RANDY
Middle Name:LYNN
Last Name:POMAJZL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3008 W STOLLEY PARK RD STE 3
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68801-7492
Mailing Address - Country:US
Mailing Address - Phone:308-381-5554
Mailing Address - Fax:308-382-0839
Practice Address - Street 1:3008 W STOLLEY PARK RD
Practice Address - Street 2:SUITE 3
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68801-7493
Practice Address - Country:US
Practice Address - Phone:308-381-5554
Practice Address - Fax:308-382-0839
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE870111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor