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Individual

VIACHESLAV KHOMUTETS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
500 S BARTLETT RD, STREAMWOOD, IL 60107-1310
(352) 910-0628
Mailing address
1460 FAIRLANE DR APT 215, SCHAUMBURG, IL 60193-3530
(352) 910-0628

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
227.023390
IL
225700000X
Massage Therapist
MA104038
FL

Other

Enumeration date
11/11/2024
Last updated
11/11/2024
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