Provider Demographics
NPI:1518403294
Name:BANGS, KYLE (DC)
Entity Type:Individual
Prefix:DR
First Name:KYLE
Middle Name:
Last Name:BANGS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:502 7TH ST
Mailing Address - Street 2:STE 100
Mailing Address - City:OREGON CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97045-2246
Mailing Address - Country:US
Mailing Address - Phone:503-730-2788
Mailing Address - Fax:503-862-5043
Practice Address - Street 1:502 7TH ST STE 100
Practice Address - Street 2:
Practice Address - City:OREGON CITY
Practice Address - State:OR
Practice Address - Zip Code:97045-2246
Practice Address - Country:US
Practice Address - Phone:503-730-2788
Practice Address - Fax:503-862-5043
Is Sole Proprietor?:No
Enumeration Date:2017-01-18
Last Update Date:2020-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR5793111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor