Individual
KITTINUN KLUBDEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1606 ROCK GLEN AVE APT 8, GLENDALE, CA 91205-2075
(307) 797-1323
Mailing address
1606 ROCK GLEN AVE APT 8, GLENDALE, CA 91205-2075
(307) 797-1323
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
77799
CA
376K00000X
Nurse's Aide
01190115
CA
Other
Enumeration date
06/15/2022
Last updated
06/15/2022
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