| NPI | 1710587571 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEREMY LYMAN Director 435-678-3993 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QE0700X Clinic/Center, End-Stage Renal Disease (ESRD) Treatment |
| Enumeration Date | 2020-10-29 |
| Last Update Date | 2020-10-29 |