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Individual

KYLE FITZGERALD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CHW

Contact information

Practice address
2065 NE TUCSON WAY APT 110, BEND, OR 97701-5182
(541) 383-3005
(541) 383-1883
Mailing address
600 SW COLUMBIA ST STE 6250, BEND, OR 97702-1099
(541) 383-3005
(541) 383-1883

Taxonomy

Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
108009
OR

Other

Enumeration date
01/23/2023
Last updated
01/23/2023
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