Organization
LDBH, LLC
Active
Other names
Liberty Dialysis at Lakeland Watervliet
Organization subpart
No
Provider details
NPI number
Authorized official
RYAN B PARDO (VICE PRESIDENT)
(206) 236-5001
Entity
Organization
Contact information
Practice address
400 MEDICAL PARK DR, WATERVLIET, MI 49098-9225
(269) 684-0116
(269) 684-0271
Mailing address
7650 SE 27TH ST, SUITE 200, MERCER ISLAND, WA 98040-3060
(206) 588-8621
(206) 588-8661
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Enumeration date
01/05/2011
Last updated
08/15/2012
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