Organization · Type 2 NPI
Dca of So Ga LLC
End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Valdosta, GA
NPI number
1790748101
Active
Practice location
3564 N Crossing Cir Ste A
Valdosta, GA 31602-6413
Fax (229) 249-0775
Mailing address
PO Box 19119
Jonesboro, AR 72403-6601
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...
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About NPI 1790748101
Dca of So Ga LLC's National Provider Identifier is 1790748101, issued on Apr 7, 2006. The primary taxonomy on file is End-Stage Renal Disease (ESRD) Treatment Clinic/Center (261QE0700X), and the practice location is in Valdosta, GA. The record was last updated on Jul 17, 2014.