Individual
MRS. JILL GREEN PEDERSEN
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
407 E RUSSELL AVE, BLDG. A, SUITE 4, WARRENSBURG, MO 64093-1242
(660) 429-4700
(660) 429-0500
Mailing address
304 KNOLL DR, WARRENSBURG, MO 64093-2002
(660) 747-8466
(660) 429-0500
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2000173562
MO
Other
Enumeration date
06/02/2006
Last updated
07/08/2007
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