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General NPI Number Information
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NPI Number | 1235642745
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Entity Type | Organization
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Legal Business Name | MARYANN GENESS
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Dates
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Enumeration Date | 11/07/2017
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Last Update Date | 11/07/2017
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Provider Practice Location Address
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Address Line | 258 A ST STE 8
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City | ASHLAND
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State | OR
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Zip | 97520-1990
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Country | US
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Telephone | 541-324-9736
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Fax | 541-708-6261
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Provider Business Mailing Address
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Address Line | PO BOX 1166
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City | ASHLAND
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State | OR
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Zip | 97520-0039
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Country | US
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Telephone | 541-324-9736
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Fax | 541-708-6261
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Authorized Official
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Title or Position | SOLE PROPRIETOR
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Name | DR. MARYANN GENESS
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Credential | DC
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Telephone | 541-324-9736
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AC160346
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 3762
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License Number State | OR
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Taxonomy #3
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 3770
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License Number State | OR
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