| NPI | 1760141980 |
|---|---|
| Doing Business As | GENEVIVE |
| Entity Type | Organization |
| Authorized Contact | AMANDA TUFANO CEO And Treasurer 469-231-1545 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208D00000X General Practice |
| Enumeration Date | 2021-12-15 |
| Last Update Date | 2021-12-15 |