Provider Demographics
NPI:1952035966
Name:RATANAKUL, KIANA (LAT, ATC)
Entity Type:Individual
Prefix:
First Name:KIANA
Middle Name:
Last Name:RATANAKUL
Suffix:
Gender:F
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7245 SUMMER AIR AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89179-1307
Mailing Address - Country:US
Mailing Address - Phone:702-451-0118
Mailing Address - Fax:
Practice Address - Street 1:7245 SUMMER AIR AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89179-1307
Practice Address - Country:US
Practice Address - Phone:702-451-0118
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-14
Last Update Date:2022-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer