Individual
DR. KYLE ROGER GRUNWALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
12325 SW HORIZON BLVD STE 223, BEAVERTON, OR 97007-9474
(503) 747-3388
(503) 747-7534
Mailing address
3540 SW HUME ST, PORTLAND, OR 97219-3758
(208) 964-4064
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
6395
OR
Other
Enumeration date
09/23/2024
Last updated
09/23/2024
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