Genesis Medical Group, Llc.
NPI #1457517138 in Lake Oswego, Oregon
Provider Information
- NPI Number
- 1457517138
- Entity Type
- Organization
- Organization Name
- Genesis Medical Group, Llc.
- Primary Specialty
- Prosthetic/Orthotic Supplier
- Enumeration Date
- Aug 1, 2008
- Last Updated
- Apr 3, 2012
Practice Location
- Address
- 16679 BOONES FERRY RD STE 215
- City
- Lake Oswego
- State
- Oregon
- ZIP Code
- 97035-4368
- 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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