PROVO KIDNEY CARE LLC

WALTHAM, MA
NPI1972056893
Entity TypeOrganization
Authorized ContactPAMELA VP
Vice President
480-639-7186
Organization Subpart ?No
Primary Taxonomy207RN0300X Internal Medicine, Nephrology
(Licence: UT  001)
Enumeration Date2016-07-27
Last Update Date2016-07-27
Business Address
PROVO KIDNEY CARE LLC
920 WINTER ST
WALTHAM, MA 02451-1521
Phone number: 480-639-7186
Mailing Address
PROVO KIDNEY CARE LLC
920 WINTER ST
WALTHAM, MA 02451-1521
Phone number: 480-639-7186