| NPI | 1417556465 |
|---|---|
| Doing Business As | GENESIS LIFESTYLE MEDICINE |
| Entity Type | Organization |
| Authorized Contact | ALEX SPINOSO Authorized Official 725-867-3337 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2020-10-21 |
| Last Update Date | 2021-02-08 |