Individual
VIENGKHONE SAYADETH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5649 N PALM AVE, FRESNO, CA 93704-1851
(559) 222-6262
Mailing address
2393 E JORDAN AVE, FRESNO, CA 93720-0270
(559) 577-0415
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
80264
CA
Other
Enumeration date
05/24/2023
Last updated
05/24/2023
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