Individual
MRS. ANICHAKANT RUANGRAM COQUIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
955 CARRILLO DR STE 103, LOS ANGELES, CA 90048-5400
(310) 870-0019
Mailing address
732 N KENMORE AVE, LOS ANGELES, CA 90029-2508
(323) 633-9547
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
49730
CA
Other
Enumeration date
03/10/2023
Last updated
03/10/2023
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