Individual
KETSARIN CHAIYANUT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MMP
Contact information
Practice address
348 MIRACLE STRIP PKWY SW UNIT 11, FORT WALTON BEACH, FL 32548-5200
(850) 716-9959
Mailing address
208 3RD ST SE UNIT G, FORT WALTON BEACH, FL 32548-7214
(161) 975-3476
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA98574
FL
Other
Enumeration date
10/10/2022
Last updated
07/27/2023
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