| NPI | 1326338963 |
|---|---|
| Doing Business As | DAVITA MEDICAL GROUP |
| Entity Type | Organization |
| Authorized Contact | JOHN G LIETHEN Secretary 952-205-6262 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: NM 01759) |
| Enumeration Date | 2011-04-17 |
| Last Update Date | 2019-08-22 |