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Mr. Scott Gould Kingphavong, LMT
Massage Therapist in Oak Forest, Illinois
NPI 1710333638

Scott Gould Kingphavong is a Massage Therapist based in Oak Forest, IL. Scott Gould Kingphavong practices in Oak Forest, IL and has the professional credentials of LMT. The NPI Number for Scott Gould Kingphavong is 1710333638 and holds a License No. 227.014953 (Illinois).

The current practice location address for Scott Gould Kingphavong is 5936 Essex Rd, Oak Forest, IL and can be reached out via phone at 779-774-5493. You can also correspond with Scott Gould Kingphavong through the mailing address at 5936 ESSEX RD, OAK FOREST, IL - 60452-2824 (mailing address contact number: 779-774-5493).

Location: 5936 Essex Rd, Oak Forest, IL, 60452-2824
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1710333638
Provider Name
Scott Gould Kingphavong
Credential
LMT
Provider Entity Type
Individual
Gender
Male
Address
5936 Essex Rd, Oak Forest, IL, 60452-2824
Phone Number
779-774-5493
Fax Number
Provider Enumeration Date
05/10/2016
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
5936 Essex Rd
City
Oak Forest
State
Illinois
Zip
60452-2824
Phone Number
779-774-5493
Fax Number
person
Provider Business Mailing Address Details
Address
5936 Essex Rd
City
Oak Forest
State
Illinois
Zip
60452-2824
Phone Number
779-774-5493
Fax Number
person
Provider's Taxonomy Details 1
Type
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Classification
Massage Therapist
Speciality
-
Taxonomy
225700000X
License No.
227.014953 (Illinois)
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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