Organization
VICTORY SPINE AND SPORT PLLC
Active
Other names
Victory Spine and Sport
Organization subpart
No
Provider details
NPI number
Authorized official
DUSTIN HENRY DC (OWNER)
(360) 818-4626
Entity
Organization
Contact information
Practice address
16508 SE 24TH ST STE 203, VANCOUVER, WA 98683-4321
(360) 818-4626
(360) 208-0293
Mailing address
16508 SE 24TH ST STE 203, VANCOUVER, WA 98683-4321
(360) 818-4626
(360) 208-0293
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
11/06/2020
Last updated
12/02/2021
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