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Individual
PHOUKHONG LAMVICHIT
Active
Individual
PHOUKHONG LAMVICHIT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038012476
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
038012476
ILLINOIS STATE PROFESSIONAL LICENSE
IL
Enumeration date
08/01/2013
Last updated
04/19/2021
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