Provider Demographics
NPI:1659004554
Name:PEPPERS STEPPIN LIFESTYLE FITNESS
Entity Type:Organization
Organization Name:PEPPERS STEPPIN LIFESTYLE FITNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED PERSONAL TRAINER
Authorized Official - Prefix:
Authorized Official - First Name:KYAUN
Authorized Official - Middle Name:TYRELL
Authorized Official - Last Name:PEPPERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-292-4559
Mailing Address - Street 1:2519 AIRPORT BLVD NW STE A
Mailing Address - Street 2:
Mailing Address - City:WILSON
Mailing Address - State:NC
Mailing Address - Zip Code:27896-9603
Mailing Address - Country:US
Mailing Address - Phone:252-292-4559
Mailing Address - Fax:
Practice Address - Street 1:2519 AIRPORT BLVD NW STE A
Practice Address - Street 2:
Practice Address - City:WILSON
Practice Address - State:NC
Practice Address - Zip Code:27896-9603
Practice Address - Country:US
Practice Address - Phone:252-360-4941
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-07
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service