Individual
MANTANA TANTISIRIRAT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
X
Contact information
Practice address
530 S MANHATTAN PL APT 301, LOS ANGELES, CA 90020-5321
(949) 981-4245
Mailing address
530 S MANHATTAN PL APT 301, LOS ANGELES, CA 90020-5321
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
86118
CA
Other
Enumeration date
03/04/2026
Last updated
03/04/2026
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