JUSTIN SOUVANLASY

PORTLAND, OR
NPI1144957689
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy111N00000X Chiropractor
(Licence: OR  6169)
Enumeration Date2022-08-04
Last Update Date2023-03-30
Business Address
JUSTIN SOUVANLASY DC
8136 SE FOSTER RD
PORTLAND, OR 97206-4288
Phone number: 503-374-9995
Mailing Address
JUSTIN SOUVANLASY DC
9841 SE HULT ST
PORTLAND, OR 97266-1341
Phone number: 971-240-8512