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Fanta Kysone Sychampanakhone, CMT
Massage Therapist in Sartell, Minnesota
NPI 1881319085

Fanta Kysone Sychampanakhone is a Massage Therapist based in Sartell, MN. Fanta Kysone Sychampanakhone practices in Sartell, MN and has the professional credentials of CMT. The NPI Number for Fanta Kysone Sychampanakhone is 1881319085 and holds a License No. 768918 (Minnesota).

The current practice location address for Fanta Kysone Sychampanakhone is 234 Pine Cone Rd Ste B, Sartell, MN and can be reached out via phone at 320-253-5255 and via fax at 320-253-5260.

Location: 234 Pine Cone Rd Ste B, Sartell, MN, 56377-2504
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1881319085
Provider Name
Fanta Kysone Sychampanakhone
Credential
CMT
Provider Entity Type
Individual
Gender
Female
Address
234 Pine Cone Rd Ste B, Sartell, MN, 56377-2504
Phone Number
320-253-5255
Fax Number
320-253-5260
Provider Enumeration Date
10/10/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
234 Pine Cone Rd Ste B
City
Sartell
State
Minnesota
Zip
56377-2504
Phone Number
320-253-5255
Fax Number
320-253-5260
person
Provider Business Mailing Address Details
Address
234 Pine Cone Rd Ste B
City
Sartell
State
Minnesota
Zip
56377-2504
Phone Number
320-253-5255
Fax Number
320-253-5260
person
Provider's Taxonomy Details 1
Type
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Classification
Massage Therapist
Speciality
-
Taxonomy
225700000X
License No.
768918 (Minnesota)
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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