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1144957689
JUSTIN SOUVANLASY
PORTLAND, OR
NPI
1144957689
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
111N00000X Chiropractor
(Licence: OR 6169)
Enumeration Date
2022-08-04
Last Update Date
2023-03-30
Business Address
JUSTIN SOUVANLASY DC
8136 SE FOSTER RD
PORTLAND, OR 97206-4288
Phone number: 503-374-9995
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Mailing Address
JUSTIN SOUVANLASY DC
9841 SE HULT ST
PORTLAND, OR 97266-1341
Phone number: 971-240-8512
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