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Krittussapon Kheawbua
Massage Therapist in Hawthorne, California
NPI 1194473710

Krittussapon Kheawbua is a Massage Therapist based in Hawthorne, CA. Krittussapon Kheawbua practices in Hawthorne, CA. The NPI Number for Krittussapon Kheawbua is 1194473710 and holds a License No. 85742 (California).

The current practice location address for Krittussapon Kheawbua is 14030 Chadron Ave Apt 235, Hawthorne, CA and can be reached out via phone at 310-456-4999.

Location: 14030 Chadron Ave Apt 235, Hawthorne, CA, 90250-8247
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1194473710
Provider Name
Krittussapon Kheawbua
Credential
Provider Entity Type
Individual
Gender
Male
Address
14030 Chadron Ave Apt 235, Hawthorne, CA, 90250-8247
Phone Number
310-456-4999
Fax Number
Provider Enumeration Date
03/14/2022
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
54132 05 CA
institution
Provider Business Practice Location Address Details
Address
14030 Chadron Ave Apt 235
City
Hawthorne
State
California
Zip
90250-8247
Phone Number
310-456-4999
Fax Number
person
Provider Business Mailing Address Details
Address
14030 Chadron Ave Apt 235
City
Hawthorne
State
California
Zip
90250-8247
Phone Number
310-456-4999
Fax Number
person
Provider's Taxonomy Details 1
Type
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Classification
Massage Therapist
Speciality
-
Taxonomy
225700000X
License No.
85742 (California)
Definition
An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes.
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