Individual
KYLE BANGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CSCS
Contact information
Practice address
845 SW 30TH ST, CORVALLIS, OR 97331-8629
(541) 768-1428
Mailing address
845 SW 30TH ST, CORVALLIS, OR 97331-8629
(541) 768-1428
Taxonomy
Speciality
Code
Description
License number
State
174H00000X
Health Educator
Primary
—
—
Other
Enumeration date
09/12/2016
Last updated
09/12/2016
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