| NPI | 1558968420 |
|---|---|
| Doing Business As | GENESIS LIFESTYLE MEDICINE |
| Entity Type | Organization |
| Authorized Contact | ALEX SPINOSO Authorized Official 702-805-1425 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2020-10-05 |
| Last Update Date | 2020-10-05 |