KIDNEY REPLACEMENT THERAPIES, SC
Ambulatory Health at Green Bay Rd, Kenosha, WI

License number
Wisconsin 40695-20
Category
Ambulatory Health
Type
End-Stage Renal Disease (ESRD) Treatment
Owner
Name: GANESH N PULLA MD
Title: DOCTOR
Phone: (262) 564-8636
Address
Address
6125 Green Bay Rd SUITE 100, Kenosha, WI 53142
National Provider ID: 1720283302
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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KIDNEY REPLACEMENT THERAPIES, S.C

6125 Greenbay Rd #100, Kenosha, WI 53142

Registration:
Jul 15, 2005
State ID:
K034360
Business type:
Service Corporation

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