Individual
TEDIJO PEDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
400 S CLARK ST, BUTTE, MT 59701-2328
(406) 723-2500
Mailing address
2034 COLT DR, P.O. BOX 55, VICTOR, MT 59875
(406) 930-2150
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
ATR-LAT-LIC-2508
MT
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
07/02/2020
Last updated
07/08/2022
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