Doctor Name: | IVY R PEDERSEN |
NPI Number: | 1598073637 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PT |
License Number: | 412 |
Business Practice Address: | 1648 Ellis St, Ste 201 Bozeman, MT - 59715 |
Business Phone Number: | 4065853701 |
Business Fax Number: | 4065869708 |
Mailing Address: | 1648 Ellis St,, Ste 201 BOZEMAN |
State: | MT |
Postal Code: | 59715 |
Phone Number: | 4065853701 |
Fax Number: | 4065869708 |
NPI Enumeration Date: | 09/23/2010 |
NPI Last Update Date: | 06/20/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 412 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | AK |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |