Pederson, Randall Edward
Pederson, Randall Edward is an sole proprietor health care provider with primary practice located at 131 Minnesota Ave E , Glenwood MN 56334-1627. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Pederson, Randall Edward can be contacted via phone (320) 634-4737.Contact Information
Primary practice address
131 Minnesota Ave E
Glenwood MN 56334-1627
Phone: (320) 634-4737
Fax: (320) 634-4737
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Chiropractic Providers / Chiropractor | 111N00000X | 1828 | Minnesota |
Profile Details
| NPI number | 1114094182 |
|---|---|
| LBN Legal business name | Pederson, Randall Edward |
| Credentials | Doctor of Chiropractic (DC) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 28th, 2006 |
| Last updated | Jul 9th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1114094182 | NPPES |
| Minnesota | Other | 1C090PE | BCBS IPN |
| Minnesota | Other | 49316PE | BCBS IPN |
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