Individual
THAI MAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
11562 KNOTT ST STE 17, GARDEN GROVE, CA 92841-1823
(714) 448-9776
Mailing address
11742 OLD FASHION WAY, GARDEN GROVE, CA 92840-2115
(714) 273-6175
Taxonomy
Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
Primary
34463
CA
Other
Enumeration date
02/26/2019
Last updated
02/26/2019
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