| NPI | 1114167947 |
|---|---|
| Other Name | JERRY R PEDERSON, O.D., P.C. |
| Entity Type | Organization |
| Authorized Contact | JON FREDERICK PEDERSON Doctor 303-798-5533 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CO 2468) |
| Enumeration Date | 2009-03-06 |
| Last Update Date | 2009-03-06 |