Individual
TIPHAVEE KETLEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
245 MAIN ST, VENICE, CA 90291-2590
(310) 399-5566
Mailing address
5846 1/2 LIVE OAK ST, BELL GARDENS, CA 90201-4856
(562) 579-8659
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
86713
CA
Other
Enumeration date
02/19/2026
Last updated
02/20/2026
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