Legacy Dialysis of Reston LLC

NPI #1720759814 in Reston, Virginia

Provider Information

NPI Number: 1720759814
Entity Type: Organization
Organization Name: Legacy Dialysis of Reston LLC
Primary Specialty: Clinic/Center - End-Stage Renal Disease (ESRD) Treatment
Enumeration Date: Sep 28, 2021
Last Updated: May 26, 2023

Practice Location

Address: 1897 PRESTON WHITE DR STE 105
City: Reston
State: Virginia
ZIP Code: 20191-5475
Phone: (954) 781-7741

Authorized Official

Name: NICOLE JOYNER
Title: ADMIN
Phone: (954) 729-5434

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - End-Stage Renal Disease (ESRD) Treatment — End-Stage Renal Disease (ESRD) Treatment	261QE0700X	Primary

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