Genesis Medical Group, Llc.
NPI #1326290248 in Longview, Washington
Provider Information
- NPI Number
- 1326290248
- Entity Type
- Organization
- Organization Name
- Genesis Medical Group, Llc.
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- GENESIS MEDICAL GROUP, LLC.
- Primary Specialty
- Prosthetic/Orthotic Supplier
- Enumeration Date
- Oct 22, 2008
- Last Updated
- Apr 3, 2012
Practice Location
- Address
- 1338 COMMERCE AVE STE D
- City
- Longview
- State
- Washington
- ZIP Code
- 98632-3743
- Phone
- (503) 699-1911
Authorized Official
- Name
- MR. WYATT JAMES BROWN, CPED
- Title
- DIRECTOR OF OPERATION
- Phone
- (503) 699-1911
Specialties & Taxonomy Codes
| Specialty |
|---|
| Prosthetic/Orthotic Supplier |
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