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General NPI Number Information
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NPI Number | 1164989513
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Entity Type | Organization
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Legal Business Name | GENESIS CHIROPRACTIC & WELLNESS CENTER
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Dates
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Enumeration Date | 02/21/2019
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Last Update Date | 03/11/2025
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Provider Practice Location Address
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Address Line | 1141 N BRAND BLVD STE 200
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City | GLENDALE
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State | CA
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Zip | 91202-2577
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Country | US
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Telephone | 818-484-8944
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Fax | 818-484-8943
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Provider Business Mailing Address
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Address Line | 1141 N BRAND BLVD STE 200
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City | GLENDALE
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State | CA
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Zip | 91202-2577
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Country | US
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Telephone | 818-484-8944
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Fax | 818-484-8943
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Authorized Official
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Title or Position | BUSINESS OWNER
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Name | KARO TER-NERSESYAN
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Credential | DC
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Telephone | 818-484-8944
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NI0013X
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Taxonomy Name | Independent Medical Examiner Chiropractor
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License Number |
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License Number State |
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