| NPI | 1790382513 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MYLE THI TRAN Practice Manager 859-912-7716 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QE0700X Clinic/Center End-Stage Renal Disease (ESRD) Treatment |
| Enumeration Date | 2020-10-05 |
| Last Update Date | 2020-10-05 |