| NPI | 1487692950 |
|---|---|
| Doing Business As | LIBERTY DIALYSIS-IDAHO FALLS LLC |
| 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 | 2006-06-04 |
| Last Update Date | 2023-10-17 |