NPI | 1073846655 |
---|---|
Doing Business As | LIBERTY DIALYSIS - WEST JORDAN |
Entity Type | Organization |
Authorized Contact | BARRY L. BLANTON Vice President 781-699-9000 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QE0700X Clinic/Center, End-Stage Renal Disease (ESRD) Treatment |
Enumeration Date | 2009-09-14 |
Last Update Date | 2023-10-17 |