NPI | 1255397170 |
---|---|
Doing Business As | FORT WALTON BEACH DIALYSIS |
Entity Type | Organization |
Authorized Contact | THOMAS O. USILTON Group Vice President 770-541-7922 |
Organization Subpart ? | No |
Primary Taxonomy | 261QE0700X Clinic/Center, End-Stage Renal Disease (ESRD) Treatment |
Enumeration Date | 2006-04-21 |
Last Update Date | 2007-07-12 |