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1104261288
JONATHAN PEDERSON
ANKENY, IA
NPI
1104261288
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist Athletic Trainer
(Licence: IA 001110)
Enumeration Date
2013-05-03
Last Update Date
2013-05-03
Business Address
JONATHAN PEDERSON ATC
301 N ANKENY BLVD
ANKENY, IA 50023-1730
Phone number: 515-965-1422
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Mailing Address
JONATHAN PEDERSON ATC
3032 SW ARLAN LN
ANKENY, IA 50023-6827
Phone number:
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