Organization
SOUTHGLENN EYECARE, PC
Active
Other names
Jerry R Pederson, O.D., P.C.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JON FREDERICK PEDERSON O.D. (DOCTOR)
(303) 798-5533
Entity
Organization
Contact information
Practice address
6650 S VINE ST, 160, CENTENNIAL, CO 80121-2735
(303) 798-5533
(303) 798-2800
Mailing address
6650 S VINE ST, 160, CENTENNIAL, CO 80121-2735
(303) 798-5533
(303) 798-2800
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2468
CO
Other
Enumeration date
03/06/2009
Last updated
03/06/2009
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