| NPI | 1972572949 |
|---|---|
| Doing Business As | WYLDS ROAD DIALYSIS |
| Entity Type | Organization |
| Authorized Contact | JOHN WINSTEL Chief Accounting Officer 253-733-4501 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QE0700X Clinic/Center End-Stage Renal Disease (ESRD) Treatment (Licence: GA ESRD001090) |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2021-10-26 |