Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. SCOTT GOULD KINGPHAVONG, LMT
Active Sole ProprietorMR. SCOTT GOULD KINGPHAVONG, LMT is a Massage Therapist healthcare provider located in OAK FOREST, Illinois. NPI 1710333638 is currently active in the NPPES registry. Verify at CMS.
Massage Therapist · OAK FOREST, IL
Registration Details
- NPI Number
- 1710333638
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- May 10, 2016 (10.273412732312 yrs)
- Last Updated
- Oct 1, 2020
- License
-
227.014953 (IL)
- Sole Proprietor
- Yes
Practice Information
- Address
-
5936 ESSEX RDOAK FOREST, IL, 604522824Browse IL providers · Browse ZIP 60452
- Phone
- 7797745493
- Primary Specialty
-
Massage Therapist
225700000X
Other Massage Therapist Providers in OAK FOREST, IL
| Name | Credential | NPI |
|---|---|---|
| MS. TYLER JOHNSON | LMT, CCMA, CNA | 1669195525 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.