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Organization
GARFIELD DIALYSIS VENTURE LLC
Active
Organization
GARFIELD DIALYSIS VENTURE LLC
Active
Other names
Humboldt Ridge Dialysis Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BARRY LEE LUCKENBILL (MANAGING MEMBER)
(414) 777-5200
Entity
Organization
Contact information
Practice address
2211 N HUMBOLDT BLVD, MILWAUKEE, WI 53212-3507
(414) 336-7200
(414) 777-5210
Mailing address
2514 S 102ND ST, SUITE 120, WEST ALLIS, WI 53227-2142
(414) 777-5200
(414) 777-5210
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
NULL
Other
Enumeration date
11/16/2007
Last updated
12/27/2007
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