KIDNEY REPLACEMENT THERAPIES SC NPI 1720283302

NPI Information

KIDNEY REPLACEMENT THERAPIES, SC is an end-stage renal disease (esrd) treatment clinic center in Kenosha, WI. KIDNEY REPLACEMENT THERAPIES, SC NPI is 1720283302. The provider is registered as an organization entity type.

The provider's business location address is:

6125 GREEN BAY RD
SUITE 100
KENOSHA, WI
ZIP 53142-928
Phone: (262) 564-8636
Fax: (262) 564-8637

The provider's authorized official is Ganesh N Pulla .
The authorized official title is Doctor and has the following contact phone number (262) 564-8636.

The enumeration date for this NPI number is 6/15/2007 and was last updated on 12/19/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

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