Individual
DR. KYLE JAMES VILLARUZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
1619 NW HAWTHORNE AVE STE 110, GRANTS PASS, OR 97526-6008
(541) 471-7056
Mailing address
2932 GOLDENWAVE, ROCKWALL, TX 75032-7319
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
DP211294
OR
213E00000X
Podiatrist
T58-2019
TX
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
07/03/2018
Last updated
05/19/2022
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