Individual
JACK E PEDERSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D. C.
Contact information
Practice address
1235 MAIN ST, SWEET HOME, OR 97386-1609
(541) 367-2105
Mailing address
1235 MAIN ST, SWEET HOME, OR 97386-1609
(541) 367-2105
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1401
OR
Other
Enumeration date
10/23/2006
Last updated
07/08/2007
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