Organization · Type 2 NPI
Ponderosa Pine, LLC
End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Lone Tree, CO
NPI number
1407525447
Active
Practice location
9777 S Yosemite St Ste 130AB&C
Lone Tree, CO 80124-3191
Fax (720) 798-3755
Mailing address
PO Box 251549
Plano, TX 75025-1500
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| End-Stage Renal Disease (ESRD) Treatment Clinic/Center Primary | 261QE0700X | None listed |
End-Stage Renal Disease (ESRD) Treatment Clinic/Center: Definition to come...
About NPI 1407525447
Ponderosa Pine, LLC's National Provider Identifier is 1407525447, issued on Sep 13, 2021. The primary taxonomy on file is End-Stage Renal Disease (ESRD) Treatment Clinic/Center (261QE0700X), and the practice location is in Lone Tree, CO. The record was last updated on Sep 13, 2021.