| NPI | 1801998224 |
|---|---|
| Doing Business As | SOUTHEAST TYLER DIALYSIS |
| Doing Business As | SOUTHEAST TYLER |
| 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 | 2006-09-05 |
| Last Update Date | 2024-02-01 |