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Organization

ADVANCED SPORT AND SPINE CHIROPRACTIC LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JUSTIN CORYELL DC (OWNER)
(541) 852-8806
Entity
Organization

Contact information

Practice address
85203 JASPER PARK RD, PLEASANT HILL, OR 97455-9773
(541) 852-8806
Mailing address
85203 JASPER PARK RD, PLEASANT HILL, OR 97455-9773
(541) 852-8806

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary

Other

Enumeration date
01/22/2021
Last updated
01/25/2021
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