Individual
JUSTIN PELHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS RD LD
Contact information
Practice address
4920 NE STALLINGS DR, NACOGDOCHES, TX 75965-1254
(936) 569-9481
(936) 568-3365
Mailing address
4920 NE STALLINGS DR, NACOGDOCHES, TX 75965-1254
(936) 569-9481
(936) 568-3365
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DT82286
TX
Other
Enumeration date
05/19/2014
Last updated
05/19/2014
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