NPI | 1104871573 |
---|---|
Doing Business As | JACKSON SOUTHWEST DIALYSIS |
Entity Type | Organization |
Authorized Contact | JOHN WINSTEL Chief Accounting Officer 253-733-4501 |
Organization Subpart ? | No |
Primary Taxonomy | 261QE0700X Clinic/Center End-Stage Renal Disease (ESRD) Treatment |
Enumeration Date | 2006-05-24 |
Last Update Date | 2022-07-29 |