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General NPI Number Information
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NPI Number | 1013228436
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Entity Type | Organization
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Legal Business Name | GENESIS TESTING AND THERAPY
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Dates
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Enumeration Date | 06/30/2010
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Last Update Date | 07/29/2010
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Provider Practice Location Address
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Address Line | 3960 PATIENT CARE WAY SUITE 113 GT
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City | LANSING
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State | MI
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Zip | 48911-4275
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Country | US
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Telephone | 517-702-3200
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Fax | 517-702-2944
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Provider Business Mailing Address
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Address Line | 3960 PATIENT CARE WAY SUITE 113 GT
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City | LANSING
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State | MI
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Zip | 48911-4275
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Country | US
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Telephone | 517-702-3200
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Fax | 517-702-2944
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Authorized Official
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Title or Position | OWNER
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Name | DR. FLOYD G GOODMAN
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Credential | MD
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Telephone | 517-702-3200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QL0400X
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Taxonomy Name | Lithotripsy Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QR0208X
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Taxonomy Name | Mobile Radiology Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QX0100X
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Taxonomy Name | Occupational Medicine Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 261QR0401X
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Taxonomy Name | Comprehensive Outpatient Rehabilitation Facility (CORF)
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 261QM1200X
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Taxonomy Name | Magnetic Resonance Imaging (MRI) Clinic/Center
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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