Organization
PPN HOME DIALYSIS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRAD H YUAN MD (MEDICAL DIRECTOR/OWNER)
(719) 632-7641
Entity
Organization
Contact information
Practice address
2002 LELARAY ST, SUITE 100, COLORADO SPRINGS, CO 80909-2804
(719) 632-7641
(719) 632-2925
Mailing address
2002 LELARAY ST, SUITE 100, COLORADO SPRINGS, CO 80909-2804
(719) 632-7641
(719) 632-2925
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Enumeration date
11/16/2009
Last updated
11/16/2009
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