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Individual

KYLE WILLIAM BAUER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
7301 POE AVE, DAYTON, OH 45414-2559
(937) 280-4631
Mailing address
4317 FERNBROOK ST, KETTERING, OH 45440-1514
(937) 723-1590

Taxonomy

Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
0002714
OH

Other

Enumeration date
07/25/2022
Last updated
07/25/2022
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