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Individual

HOUSTON PEPPER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
875 PERIMETER DR # MS 2401, MOSCOW, ID 83844-9803
(562) 889-6896
Mailing address
6158 DUNROBIN AVE, LAKEWOOD, CA 90713-1036

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
CA

Other

Enumeration date
06/01/2018
Last updated
06/01/2018
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