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1346002250
SY LABTHAVIKUL
PORTLAND, OR
NPI
1346002250
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: OR 9796)
Enumeration Date
2024-01-25
Last Update Date
2024-01-25
Business Address
MR. SY LABTHAVIKUL PTA
10915 SE STARK ST
PORTLAND, OR 97216-3348
Phone number: 503-261-1120
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Mailing Address
MR. SY LABTHAVIKUL PTA
412 SE 30TH PL
PORTLAND, OR 97214-1921
Phone number: 845-598-7495
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