| NPI | 1710657457 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN KELSEY Director Of Operations 765-418-7403 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QE0700X Clinic/Center, End-Stage Renal Disease (ESRD) Treatment |
| Enumeration Date | 2021-09-15 |
| Last Update Date | 2021-09-15 |