Randall Edward Pederson in Glenwood - Chiropractor
Randall Edward Pederson - NPI 1114094182
Randall Edward Pederson is a Chiropractor in Glenwood, Minnesota. Randall Edward Pederson practices all healthcare services and medical treatments related to Chiropractor. The NPI Number for Randall Edward Pederson is 1114094182. The last update date is 2007-07-09.
Randall Edward Pederson's current location address is 131 Minnesota Ave E, Glenwood, Minnesota. You can contact this provider via phone number 3206344737 and fax number 3206344737. The mailing address for Randall Edward Pederson is 131 Minnesota Ave E, Glenwood, Minnesota. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Randall Edward Pederson |
|---|---|
| Address | 131 Minnesota Ave E, Glenwood, Minnesota |
| Phone Number | 3206344737 |
| Fax Number | 3206344737 |
| Sole Proprietor | Y |
| Credentials | DC |
NPI Number Detail
| NPI Number | 1114094182 |
|---|---|
| Provider Enumeration Date | 2006-11-28 |
| Last Updated Date | 2007-07-09 |
Provider Mailing Address Detail
| Address | 131 Minnesota Ave E |
|---|---|
| City | Glenwood |
| State | Minnesota (MN) |
| Post Code | 563341627 |
| Phone Number | 3206344737 |
| Fax Number | 3206344737 |
Provider's Primary Taxonomy Detail
| Speciality | Chiropractor |
|---|---|
| Taxonomy | 111N00000X |
| Licence No | 1828 |
|
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 |
|---|---|---|---|
| 1C090PE | MN | BCBS IPN | |
| 49316PE | MN | BCBS MPIN |
Post Comment/ Review Below
What is the Randall Edward Pederson's 1114094182?
The Randall Edward Pederson's NPI (National Provider Identifier) Number is 1114094182. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Could you provide the complete physical address where Randall Edward Pederson is located?
The Randall Edward Pederson is situated at the following address: 131 Minnesota Ave E, Glenwood, MN, 563341627.
What is the Randall Edward Pederson's area of specialization and corresponding taxonomy classification?
The Randall Edward Pederson's specialty field is Chiropractor, and it falls under the taxonomy code 111N00000X, which categorizes healthcare providers based on their specialties.
On what date did the Centers for Medicare & Medicaid Services issue the 1114094182 to Randall Edward Pederson?
The Randall Edward Pederson received its 1114094182 assignment from the Centers for Medicare & Medicaid Services on 2006-11-28.
When was the Randall Edward Pederson's information last updated?
The Randall Edward Pederson's information was last updated on 2007-07-09.