NPI 1205453552

Tedijo Pederson, ATC

Practitioner Athletic Trainer Butte, MT

Practice location

Address: 400 S Clark St, Butte, MT 59701-2328
Phone: (406) 723-2500
Mailing address: 2034 Colt Dr P.O. Box 55, Victor, MT 59875

Registered specialties (2)

Athletic Trainer Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 2255A2300X Licence ATR-LAT-LIC-2508 (MT)

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Student in an Organized Health Care Education/Training Program

Student, Health Care Taxonomy 390200000X

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Registry record

NPI: 1205453552
Entity type: Individual
Sex (as registered): Female
NPI issued: 2 Jul 2020
Record last updated: 8 Jul 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.