Individual
BANNAPORN BARHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2198 CHASE DR, NICEVILLE, FL 32578-1606
(850) 333-8901
Mailing address
2198 CHASE DR, NICEVILLE, FL 32578-1606
(850) 333-8901
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA75344
FL
Other
Enumeration date
05/14/2026
Last updated
05/14/2026
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