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
1662 N 2ND ST, CLINTON, MO 64735-1141
(660) 890-0889
(660) 890-0892
Mailing address
1662 N 2ND ST, CLINTON, MO 64735-1141
(660) 890-0889
(660) 890-0892
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
505850404
—
MO
Enumeration date
07/19/2006
Last updated
10/05/2023
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