Individual
MICHELLE BOONTHAWESUK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RT
Contact information
Practice address
2975 NORTH SYCAMORE DR., SIMI VALLEY, CA 93065
(805) 955-6000
Mailing address
2975 NORTH SYCAMORE DR., SIMI VALLEY, CA 93065
(805) 955-6000
Taxonomy
Speciality
Code
Description
License number
State
2278G1100X
General Care Certified Respiratory Therapist
Primary
28966
CA
Other
Enumeration date
08/27/2010
Last updated
08/27/2010
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