| NPI | 1649357120 |
|---|---|
| Doing Business As | LOGANVILLE DIALYSIS |
| Entity Type | Organization |
| Authorized Contact | SAIMA BASHIR Office Manager 706-227-4075 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QE0700X Clinic/Center, End-Stage Renal Disease (ESRD) Treatment (Licence: GA ESRD001252) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2012-03-23 |