Individual
MR. GREGORY LEO PECK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPTA
Contact information
Practice address
9017 BUCKEYE DR, FONTANA, CA 92335-6007
(951) 203-9017
Mailing address
9017 BUCKEYE DR, FONTANA, CA 92335-6007
(951) 203-9017
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
2266
CA
Other
Enumeration date
09/13/2012
Last updated
09/13/2012
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