Most Relevant Information
Provider Data
| NPI Number: | 1003516642 |
| Provider Name: | COLIN HERATY |
| Entity Type: | Individual |
| Taxonomy Code: | 2255A2300X |
| Specialty: | Specialist/Technologist |
| License Number: |
Most Important Dates
| Enumeration Date: | 03/02/2023 |
| Last Updated: | 03/02/2023 |
Provider Practice Location
406 MAIN ST E
WABASHA
MN
559811427
Practice Location Phone/Fax
| Phone: | 5078585523 |
| Fax: |
Provider Mailing Location
406 MAIN ST E
WABASHA
MN
559811427
Provider Mailing Phone/Fax
| Phone: | 5078585523 |
| Fax: |