Provider Demographics
NPI:1952597924
Name:HEDLUND, RANDALL C (DC)
Entity Type:Individual
Prefix:DR
First Name:RANDALL
Middle Name:C
Last Name:HEDLUND
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 1:2583 S. HWY 14
Mailing Address - Street 2:SUITE 2
Mailing Address - City:ALBION
Mailing Address - State:NE
Mailing Address - Zip Code:68620-5910
Mailing Address - Country:US
Mailing Address - Phone:402-395-2233
Mailing Address - Fax:402-395-2575
Practice Address - Street 1:2583 S. HWY 14
Practice Address - Street 2:SUITE 2
Practice Address - City:ALBION
Practice Address - State:NE
Practice Address - Zip Code:68620-5910
Practice Address - Country:US
Practice Address - Phone:402-395-2233
Practice Address - Fax:402-395-2575
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-24
Last Update Date:2008-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1250111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
1578572624OtherNPI
NE75304294700Medicaid
1578572624OtherNPI