| NPI | 1609382159 |
|---|---|
| Doing Business As | GENESIS LASER AND VEIN CENTER |
| Entity Type | Organization |
| Authorized Contact | CHANDRA NATH PRASAD Owner 573-761-5277 |
| Organization Subpart ? | No |
| Primary Taxonomy | 202K00000X |
| Enumeration Date | 2017-12-20 |
| Last Update Date | 2018-06-16 |