Kingphavong, Scott Gould

Kingphavong, Scott Gould is an sole proprietor health care provider with primary practice located at 5936 Essex Rd , Oak Forest IL 60452-2824. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Massage Therapist, which is considered as his primary health care specialty. Kingphavong, Scott Gould can be contacted via phone (779) 774-5493.

Contact Information

Primary practice address
5936 Essex Rd Oak Forest IL 60452-2824
Phone: (779) 774-5493
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Massage Therapist 225700000X 227.014953 Illinois

Profile Details

NPI number 1710333638
LBN Legal business name Kingphavong, Scott Gould
Credentials LMT
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 10th, 2016
Last updated Oct 1st, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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