NPI | 1295021095 |
---|---|
Doing Business As | LAKE VISTA DIALYSIS |
Entity Type | Organization |
Authorized Contact | SAMUEL T WEY VP Licensure & Certification 615-341-6641 |
Organization Subpart ? | No |
Primary Taxonomy | 261QE0700X Clinic/Center, End-Stage Renal Disease (ESRD) Treatment |
Enumeration Date | 2011-06-21 |
Last Update Date | 2024-11-12 |