Organization
GENESIS RENEWAL, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REBECCA B WILLIAMSON (AUTHORIZED OFFICIAL)
(918) 685-2896
Entity
Organization
Contact information
Practice address
12810 S MEMORIAL DR UNIT 307, BIXBY, OK 74008-5506
(918) 685-2896
Mailing address
12810 S MEMORIAL DR UNIT 307, BIXBY, OK 74008-5506
(918) 685-2896
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
01/20/2020
Last updated
04/01/2026
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