Individual
JIRISUDA PISUTHIPRAKORN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
13691 GAVINA AVE UNIT 567, SYLMAR, CA 91342-2670
(818) 644-1995
(818) 591-8426
Mailing address
13691 GAVINA AVE UNIT 567, SYLMAR, CA 91342-2670
(818) 644-1995
(818) 591-8426
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
84208
CA
Other
Enumeration date
02/05/2025
Last updated
02/05/2025
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