Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2081S0010X | Sports Medicine | 47494 | CO |
N | 213ES0000X | Sports Medicine | 47494 | CO |
Y | 2081S0010X | Sports Medicine | 7245724-1205 | UT |
Y | 213ES0000X | Sports Medicine | 7245724-1205 | UT |
NPI | 1295881811 |
---|---|
Provider Name | Dr. Michelle Pepper |
First Address | Bountiful, UT 84010-7676 |
Second Address | Bountiful, UT 84010-7676 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/01/2007 |
Last Update Date | 16/11/2020 |