Organization
BACK TO GENESIS CHIROPRACTIC, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LESLIE OLSON (ADVISOR)
(678) 905-0799
Entity
Organization
Contact information
Practice address
3812 AUSTELL RD SW, MARIETTA, GA 30008-5863
(678) 905-0799
Mailing address
3812 AUSTELL RD SW, MARIETTA, GA 30008-5863
(678) 458-6544
Taxonomy
Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
Primary
CHIR008150
GA
Other
Enumeration date
07/23/2010
Last updated
03/20/2014
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