Individual
KITO PHANSANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
21939 CINCO RANCH BLVD, KATY, TX 77450-1779
(281) 240-0500
Mailing address
2222 SULLIVAN TRL, EASTON, PA 18040-7958
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2046159
TX
Other
Enumeration date
05/02/2008
Last updated
05/02/2008
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