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General NPI Number Information
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NPI Number | 1336367044
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Entity Type | Organization
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Legal Business Name | GENESYS INTEGRATED GROUP PRACTICE PC
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Dates
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Enumeration Date | 04/20/2007
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Last Update Date | 11/07/2007
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Provider Practice Location Address
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Address Line | 8447 HOLLY RD SUITE A
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City | GRAND BLANC
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State | MI
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Zip | 48439-1812
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Country | US
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Telephone | 810-603-0856
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Fax | 810-603-1635
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Provider Business Mailing Address
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Address Line | 3495 S CENTER RD
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City | BURTON
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State | MI
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Zip | 48519-1455
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Country | US
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Telephone | 810-424-2007
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Fax | 810-743-1099
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | PAUL GARSON
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Credential |
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Telephone | 810-424-2007
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State | MI
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