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1659144111
GENESIS DERMATOLOGY
LA GRANDE, OR
NPI
1659144111
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Entity Type
Organization
Authorized Contact
BRYCE A EARLE
Chief Operations Manager
541-663-0007
Organization Subpart ?
No
Primary Taxonomy
207N00000X Dermatology
Enumeration Date
2023-11-06
Last Update Date
2023-11-06
Business Address
GENESIS DERMATOLOGY
1902 4TH ST STE 3
LA GRANDE, OR 97850-2558
Phone number: 541-663-0007
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Mailing Address
GENESIS DERMATOLOGY
1902 4TH ST STE 3
LA GRANDE, OR 97850-2558
Phone number: 541-663-0007
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