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Individual
MR. TRAIRUD-JACK WATANACHAIYOT
Active
Individual
MR. TRAIRUD-JACK WATANACHAIYOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.T.
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070-025183
IL
225100000X
Physical Therapist
29013
NY
Other
Enumeration date
12/09/2013
Last updated
09/23/2022
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