Individual
ASIA SURIYACHOTTAKUL BOUDDHARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4000 S EASTERN AVE STE 300, LAS VEGAS, NV 89119-0826
(702) 734-2732
(702) 737-1453
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
NV
Other
Enumeration date
10/11/2024
Last updated
03/16/2026
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