Individual
KYLE D HOMERTGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
147 SW SHEVLIN HIXON DR STE 204, BEND, OR 97702-1137
(541) 706-9985
(541) 408-9853
Mailing address
147 SW SHEVLIN HIXON DR STE 204, BEND, OR 97702-1137
(541) 706-9985
(541) 408-9853
Taxonomy
Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
DO151041
OR
207Q00000X
Family Medicine Physician
2075
ME
207Q00000X
Family Medicine Physician
Primary
DO151041
OR
Other
Enumeration date
03/26/2007
Last updated
03/22/2021
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