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Dr. Glenn Jay Pedersen, DC
Chiropractor in Paoli, Indiana
NPI 1083706162

Glenn Jay Pedersen is a Chiropractor based in Paoli, IN. Glenn Jay Pedersen practices in Paoli, IN and has the professional credentials of DC. The NPI Number for Glenn Jay Pedersen is 1083706162 and holds a License No. 08000852A (Indiana).

The current practice location address for Glenn Jay Pedersen is 421 Sw 1St St, Paoli, IN and can be reached out via phone at 812-252-2225 and via fax at 833-336-4142.

Location: 421 Sw 1St St, Paoli, IN, 47454-1103
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1083706162
Provider Name
Glenn Jay Pedersen
Credential
DC
Provider Entity Type
Individual
Gender
Male
Address
421 Sw 1St St, Paoli, IN, 47454-1103
Phone Number
812-252-2225
Fax Number
833-336-4142
Provider Enumeration Date
09/28/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
01682626 01 IL BLUE CROSS BLUE SHIELD
institution
Provider Business Practice Location Address Details
Address
421 Sw 1St St
City
Paoli
State
Indiana
Zip
47454
Phone Number
812-252-2225
Fax Number
833-336-4142
person
Provider Business Mailing Address Details
Address
421 Sw 1St St
City
Paoli
State
Indiana
Zip
47454
Phone Number
812-252-2225
Fax Number
833-336-4142
person
Provider's Taxonomy Details 1
Type
Chiropractic Providers
Classification
Chiropractor
Speciality
-
Taxonomy
111N00000X
License No.
08000852A (Indiana)
Definition
A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.
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