Glenn Jay Pedersen in Paoli - Chiropractor
Glenn Jay Pedersen - NPI 1083706162
Glenn Jay Pedersen is a Chiropractor in Paoli, Indiana. Glenn Jay Pedersen practices all healthcare services and medical treatments related to Chiropractor. The NPI Number for Glenn Jay Pedersen is 1083706162. The last update date is 2019-01-02.
Glenn Jay Pedersen's current location address is 421 Sw 1st St, Paoli, Indiana. You can contact this provider via phone number 8122522225 and fax number 8333364142. The mailing address for Glenn Jay Pedersen is 421 Sw 1st St, Paoli, Indiana. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Glenn Jay Pedersen |
|---|---|
| Address | 421 Sw 1st St, Paoli, Indiana |
| Phone Number | 8122522225 |
| Fax Number | 8333364142 |
| Sole Proprietor | Y |
| Credentials | D.C. |
NPI Number Detail
| NPI Number | 1083706162 |
|---|---|
| Provider Enumeration Date | 2006-09-28 |
| Last Updated Date | 2019-01-02 |
Provider Mailing Address Detail
| Address | 421 Sw 1st St |
|---|---|
| City | Paoli |
| State | Indiana (IN) |
| Post Code | 474541103 |
| Phone Number | 8122522225 |
| Fax Number | 8333364142 |
Provider's Primary Taxonomy Detail
| Speciality | Chiropractor |
|---|---|
| Taxonomy | 111N00000X |
| Licence No | 08000852A |
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Definition: A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its inte |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1682626 | IL | BLUE CROSS BLUE SHIELD |
Post Comment/ Review Below
What is the Glenn Jay Pedersen's unique identification number?
The Glenn Jay Pedersen has been assigned the NPI (National Provider Identifier) Number 1083706162 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Could you please share the complete physical address where Glenn Jay Pedersen is geographically located?
The Glenn Jay Pedersen is physically situated at the following location: 421 Sw 1St St, Paoli, IN, 474541103.
What is Glenn Jay Pedersen's primary area of medical expertise, and what taxonomy classification code corresponds to this specialized field?
The primary area of medical expertise for Glenn Jay Pedersen is Chiropractor, and the corresponding taxonomy classification code for this specialized field is 111N00000X.
On what date did the Glenn Jay Pedersen receive its 1083706162 assignment from the Centers for Medicare & Medicaid Services?
The Glenn Jay Pedersen was assigned its 1083706162 by the Centers for Medicare & Medicaid Services on 2006-09-28.
As of what date was the information pertaining to Glenn Jay Pedersen, such as address, specialty, and other details, last reviewed and confirmed to be accurate?
The information related to Glenn Jay Pedersen, including its address, specialty, and other relevant details, was last reviewed and confirmed to be accurate on 2019-01-02.