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
—
—
Other
Enumeration date
11/16/2007
Last updated
12/27/2007
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