# GENESIS HEALTH SYSTEM

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Genesis Pediatric Physical Therapy Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1902107261
- **Authorized official:** MARK G. ROGERS (CFO)
- **Authorized official phone:** (563) 421-6513

## Contact information

- **Practice address:** 2451 CORAL CT, SUITE 1, CORALVILLE, IA 52241-2837
- **Practice address phone:** (563) 421-9580
- **Mailing address:** 865 LINCOLN RD, SUITE L10, BETTENDORF, IA 52722-4190
- **Mailing address phone:** (563) 355-9200
- **Mailing address fax:** (563) 355-3419

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QP2000X | Physical Therapy Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 11/03/2010
- **Last updated:** 11/03/2010