Provider Demographics
NPI:1194055772
Name:PEPPER, LAUREN NOELLE (DC)
Entity type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:NOELLE
Last Name:PEPPER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5410 EDSON LN
Mailing Address - Street 2:SUITE 210 A
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-3107
Mailing Address - Country:US
Mailing Address - Phone:703-204-2320
Mailing Address - Fax:703-204-1618
Practice Address - Street 1:5410 EDSON LN
Practice Address - Street 2:SUITE 210 A
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-3107
Practice Address - Country:US
Practice Address - Phone:703-204-2320
Practice Address - Fax:703-204-1618
Is Sole Proprietor?:No
Enumeration Date:2010-01-05
Last Update Date:2010-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01825111N00000X
VA0104001749111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor