Organization
LIBERTY DIALYSIS - LAFAYETTE LLC
Active
Other names
Liberty Dialysis - Frankfort
Organization subpart
No
Provider details
NPI number
Authorized official
RYAN B PARDO (VICE PRESIDENT)
(206) 236-5001
Entity
Organization
Contact information
Practice address
1300 S JACKSON ST, FRANKFORT, IN 46041-3313
(765) 656-3377
Mailing address
7650 SE 27TH ST, SUITE 200, MERCER ISLAND, WA 98040-3060
(206) 236-5001
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Enumeration date
10/13/2006
Last updated
12/14/2010
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