Individual
IVY R PEDERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
16627
CO
225100000X
Physical Therapist
Primary
2360
MT
225100000X
Physical Therapist
297956
CA
225100000X
Physical Therapist
31008
AZ
225100000X
Physical Therapist
412
AK
225100000X
Physical Therapist
6531
ID
Other
Enumeration date
09/23/2010
Last updated
05/30/2023
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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