Provo Kidney Care LLC

NPI #1972056893 in Waltham, Massachusetts

Provider Information

NPI Number
1972056893
Entity Type
Organization
Organization Name
Provo Kidney Care LLC
Primary Specialty
Internal Medicine - Nephrology
Enumeration Date
Jul 27, 2016
Last Updated
Jul 27, 2016

Practice Location

Address
920 WINTER ST
ZIP Code
02451-1521
Phone
(480) 639-7186

Authorized Official

Name
PAMELA VP
Title
VICE PRESIDENT
Phone
(480) 639-7186

Specialties & Taxonomy Codes

Specialty
Internal Medicine - NephrologyNephrology

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