Organization
DESERET PEAK DIALYSIS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RYAN GENE KIDMAN (PARTNER)
(801) 930-0131
Entity
Organization
Contact information
Practice address
3333 S 900 E, STE 130, SALT LAKE CITY, UT 84106-2087
(801) 930-0131
(801) 928-5454
Mailing address
3333 S 900 E, STE 130, SALT LAKE CITY, UT 84106-2087
(801) 930-0131
(801) 928-5454
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Enumeration date
09/29/2015
Last updated
09/29/2015
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