Individual
PAWINEE PHUNKASETWATTHANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
922 FEDORA ST APT 5, LOS ANGELES, CA 90006-1436
(417) 396-7051
Mailing address
922 FEDORA ST APT 5, LOS ANGELES, CA 90006-1436
(417) 396-7051
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
85329
CA
Other
Enumeration date
10/30/2021
Last updated
11/09/2021
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