Individual
CHIDSANUPORN NARUDEESRIUTHAI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3169 ESTARA AVE, LOS ANGELES, CA 90065-2951
(323) 868-3104
Mailing address
3169 ESTARA AVE, LOS ANGELES, CA 90065-2951
(323) 868-3104
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
5292
CA
Other
Enumeration date
09/24/2020
Last updated
09/24/2020
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