Kyle D. Homertgen

NPI #1063026466 in Bend, Oregon

Provider Information

NPI Number
1063026466
Entity Type
Organization
Organization Name
Kyle D. Homertgen
Primary Specialty
Clinic/Center - Medical Specialty
Enumeration Date
Sep 2, 2020
Last Updated
Dec 30, 2020

Practice Location

Address
147 SW SHEVLIN HIXON DR STE 204
City
Bend
State
Oregon
ZIP Code
97702-1137
Phone
(541) 706-9985

Authorized Official

Name
JAMI ATTLEBERGER
Title
CREDENTIALING SPECIALIST
Phone
(541) 573-8312

Specialties & Taxonomy Codes

Specialty
Clinic/Center - Medical SpecialtyMedical Specialty

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