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Individual

MR. BARRY D. M. PEDERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OTR

Contact information

Practice address
601 GRIFFIN PL, APT A, FORT COLLINS, CO 80521-1896
(303) 579-0322
Mailing address
601 GRIFFIN PL, APT A, FORT COLLINS, CO 80521-1896
(303) 579-0322

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
3123
CO

Other

Enumeration date
01/12/2012
Last updated
05/07/2013
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