Organization
GENESIS DISC INSTITUTE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID MARK PIETSCH DC (OWNER)
(651) 702-7800
Entity
Organization
Contact information
Practice address
8425 SEASONS PKWY STE 104B, WOODBURY, MN 55125-5403
(651) 702-7800
(651) 702-7804
Mailing address
8425 SEASONS PKWY STE 104B, WOODBURY, MN 55125-5403
(651) 702-7800
(651) 702-7804
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
3581
MN
Other
Enumeration date
11/01/2006
Last updated
08/22/2020
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