Individual
RYAN PEDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC, LAT
Contact information
Practice address
13322 EXCALIBUR RD, CLERMONT, FL 34711-6695
(352) 242-2080
Mailing address
13322 EXCALIBUR RD, CLERMONT, FL 34711-6695
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AL 1539
FL
Other
Enumeration date
04/28/2008
Last updated
04/28/2008
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