Organization
DIALYSIS ACCESS CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LYSA JACKS (CREDENTIALING SPECIALIST)
(847) 388-2065
Entity
Organization
Contact information
Practice address
357 AVE HOSTOS, OFFICE PARK II SUITE 203, MAYAGUEZ, PR 00680-1507
(847) 388-2065
(866) 720-9740
Mailing address
357 AVE HOSTOS, OFFICE PARK II SUITE 203, MAYAGUEZ, PR 00680-1507
(847) 388-2065
(866) 720-9740
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
03/13/2008
Last updated
10/16/2008
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