Individual
JUSTIN BRUNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSS
Contact information
Practice address
280 NE SANTIAM BLVD, MILL CITY, OR 97360
(971) 332-5676
Mailing address
830 LINCOLN ST, AUMSVILLE, OR 97325-8961
(503) 569-5658
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
THW000108652
OR
Other
Enumeration date
05/02/2023
Last updated
05/02/2023
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