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1013286863
JUSTIN CLARK
PORTLAND, OR
NPI
1013286863
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225700000X Massage Therapist
(Licence: OR 18505)
Enumeration Date
2011-12-23
Last Update Date
2011-12-23
Business Address
-- JUSTIN CLARK LMT
12923 NW CORNELL RD #201
PORTLAND, OR 97229-5834
Phone number: 503-646-3393
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Mailing Address
-- JUSTIN CLARK LMT
12923 NW CORNELL RD #201
PORTLAND, OR 97229-5834
Phone number: 503-646-3393
Copy
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