Organization
KYLE HOMERTGEN, DO, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KYLE D HOMERTGEN D.O (PHYSICIAN)
(541) 602-4373
Entity
Organization
Contact information
Practice address
442 NW 4TH ST, SUITE 101, CORVALLIS, OR 97330-6491
(541) 758-5047
(541) 758-3713
Mailing address
PO BOX 1893, CORVALLIS, OR 97339-1893
Taxonomy
Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
Primary
DO151041
OR
Other
Enumeration date
08/19/2013
Last updated
08/19/2013
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