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Individual

CHOTIKA PORNPHOL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
22032 N 74TH LN, GLENDALE, AZ 85310-5637
(469) 915-6565
Mailing address
22032 N 74TH LN, GLENDALE, AZ 85310-5637
(469) 915-6565

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary

Other

Enumeration date
06/26/2023
Last updated
06/26/2023
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