Southeastern Renal Dialysis L.c.
NPI #1609988617 in Fort Madison, Iowa
Provider Information
- NPI Number
- 1609988617
- Entity Type
- Organization
- Organization Name
- Southeastern Renal Dialysis L.c.
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- SOUTHEASTERN RENAL DIALYSIS L.C.
- Primary Specialty
- Clinic/Center - End-Stage Renal Disease (ESRD) Treatment
- Enumeration Date
- Aug 31, 2006
- Last Updated
- Mar 16, 2012
Practice Location
- Address
- 4703 AVENUE L
- City
- Fort Madison
- State
- Iowa
- ZIP Code
- 52627-9505
- Phone
- (319) 372-7996
Authorized Official
- Name
- MRS. MARY LIECHTY
- Title
- ADMINISTRATOR
- Phone
- (319) 385-6728
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - End-Stage Renal Disease (ESRD) Treatment — End-Stage Renal Disease (ESRD) Treatment |
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