Individual
PATIPHAN WIRIYASOMBAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6881 LARSH DR, DENVER, CO 80221-2538
(720) 220-8110
Mailing address
6881 LARSH DR, DENVER, CO 80221-2538
(720) 220-8110
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT.0022272
CO
Other
Enumeration date
06/10/2019
Last updated
06/10/2019
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