Midwest Legacy Capital LLC
NPI #1972008704 in Black Creek, Wisconsin
Provider Information
- NPI Number
- 1972008704
- Entity Type
- Organization
- Organization Name
- Midwest Legacy Capital LLC
- Primary Specialty
- Clinic/Center - End-Stage Renal Disease (ESRD) Treatment
- Enumeration Date
- Mar 26, 2018
- Last Updated
- Mar 26, 2018
Practice Location
- Address
- W4233 STATE RD 54
- City
- Black Creek
- State
- Wisconsin
- ZIP Code
- 54106-8633
- Phone
- (920) 915-5202
Authorized Official
- Name
- MR. THOMAS A DUDLEY
- Title
- CEO
- Phone
- (920) 915-5202
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - End-Stage Renal Disease (ESRD) Treatment — End-Stage Renal Disease (ESRD) Treatment |
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