Wakonda Dialysis LLC

NPI #1992223556 in Salem, Utah

Provider Information

NPI Number: 1992223556
Entity Type: Organization
Organization Name: Wakonda Dialysis LLC
Primary Specialty: Clinic/Center - End-Stage Renal Disease (ESRD) Treatment
Enumeration Date: Sep 5, 2017
Last Updated: Oct 28, 2024

Practice Location

Address: 555 W STATE ROAD 164 STE 101
City: Salem
State: Utah
ZIP Code: 84653-5732
Phone: (801) 798-7903

Authorized Official

Name: SAMUEL WEY
Title: VP, LICENSURE & CERTIFICATION
Phone: (615) 341-6641

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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