Individual
KWANKAMON KHONGCHAROEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8742 MALLARD RESERVE DR UNIT 204, TAMPA, FL 33614-2361
(813) 451-4273
Mailing address
8742 MALLARD RESERVE DR UNIT 204, TAMPA, FL 33614-2361
(813) 451-4273
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA29224
FL
Other
Enumeration date
04/29/2019
Last updated
04/29/2019
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