Individual
JENNA PEDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1027 WASHINGTON AVE, DETROIT LAKES, MN 56501-3409
(218) 847-5611
(218) 844-2444
Mailing address
PO BOX 6001, FARGO, ND 58108-6001
(701) 364-8000
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
9146
MN
Other
Enumeration date
10/07/2015
Last updated
10/07/2015
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