Individual
SOPHANARITH AM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
50 DOAKS LN, MARBLEHEAD, MA 01945-3584
(617) 420-2041
Mailing address
9 VICTORIA ST, REVERE, MA 02151-3911
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
17833
MA
Other
Enumeration date
04/21/2025
Last updated
04/21/2025
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