Organization
DIALYSIS CLINIC INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DONOVAN SCHULTZ (PRESIDENT)
(615) 327-3061
Entity
Organization
Contact information
Practice address
135 COMMONS WAY, KALISPELL, MT 59901-1900
(406) 756-5565
(406) 756-7712
Mailing address
135 COMMONS WAY, KALISPELL, MT 59901-1900
(406) 756-5565
(406) 756-7712
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
10555
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0730133
—
MT
Enumeration date
07/08/2006
Last updated
10/05/2023
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