Individual
PANUPONG WARDCHAODEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1209 W SHERWIN AVE APT 703, CHICAGO, IL 60626-2254
(636) 649-4562
Mailing address
1209 W SHERWIN AVE APT 703, CHICAGO, IL 60626-2254
(636) 649-4562
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
227021294
IL
Other
Enumeration date
11/18/2021
Last updated
11/18/2021
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