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Individual

MR. GRITCHALACH PHOPHUTTHAPRASIT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
AP, DOM

Contact information

Practice address
3739 LAKE CENTER DR, MOUNT DORA, FL 32757-2363
(352) 729-2290
(386) 774-6333
Mailing address
2501 S VOLUSIA AVE STE 200, ORANGE CITY, FL 32763-9134
(386) 774-3333
(386) 410-1603

Taxonomy

Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AP4357
FL

Other

Enumeration date
05/20/2022
Last updated
08/23/2023
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