MR. Shane Marlon Pederson, P.T.

NPI #1003066853 in Palmhurst, Texas

Provider Information

NPI Number: 1003066853
Entity Type: Individual
Name: MR. Shane Marlon Pederson, P.T.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapist
Credential: P.T.
Enumeration Date: Sep 29, 2008
Last Updated: Jul 24, 2013

Practice Location

Address: 123 WEST MILE 3 ROAD
Address 2: SUITE A-103
City: Palmhurst
State: Texas
ZIP Code: 78573
Phone: (956) 585-9889

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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