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Individual

KENT PEDERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
11111 N SCOTTSDALE RD, SUITE 105, SCOTTSDALE, AZ 85254-6701
(480) 609-1080
(480) 951-7581
Mailing address
11111 N SCOTTSDALE RD, SUITE 105, SCOTTSDALE, AZ 85254-6701
(480) 609-1080
(480) 951-7581

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
5817
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
AZ0936750
BCBS OF AZ PROVIDER ID#
AZ
Enumeration date
07/28/2006
Last updated
04/26/2026
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