Individual
KONGKRIT SRISUWAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
15556 VANOWEN ST APT 5, VAN NUYS, CA 91406-5145
(626) 378-1428
Mailing address
15556 VANOWEN ST APT 5, VAN NUYS, CA 91406-5145
(626) 378-1428
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
86835
CA
Other
Enumeration date
03/04/2026
Last updated
03/04/2026
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