| NPI | 1427303494 |
|---|---|
| Former Legal Business Name | GENESIS SERVICE DOGS INC |
| Entity Type | Organization |
| Authorized Contact | DANIELLE STEM President 208-761-4884 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2012-07-17 |
| Last Update Date | 2012-07-17 |