Individual
RANDALL EDWARD PEDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
131 MINNESOTA AVE E, GLENWOOD, MN 56334-1627
(320) 634-4737
(320) 634-4737
Mailing address
131 MINNESOTA AVE E, GLENWOOD, MN 56334-1627
(320) 634-4737
(320) 634-4737
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1828
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1C090PE
BCBS IPN
MN
01
—
49316PE
BCBS MPIN
MN
Enumeration date
11/28/2006
Last updated
07/09/2007
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