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Organization

LEGACY DIALYSIS OF RESTON LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
NICOLE JOYNER (ADMIN)
(954) 729-5434
Entity
Organization

Contact information

Practice address
1897 PRESTON WHITE DR STE 105, RESTON, VA 20191-5475
(954) 781-7741
(888) 349-8679
Mailing address
100 E SAMPLE RD STE 220, POMPANO BEACH, FL 33064-3554
(954) 781-7741
(888) 349-8679

Taxonomy

Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary

Other

Enumeration date
09/28/2021
Last updated
05/26/2023
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