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Organization

GENESIS FAMILY CHIROPRACTIC SC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JASON A. LANG DC (OWNER)
(920) 731-3255
Entity
Organization

Contact information

Practice address
1730 APPLETON RD, MENASHA, WI 54952-1108
(920) 886-1055
(920) 886-1053
Mailing address
4070 W SPENCER ST, APPLETON, WI 54914-4015
(920) 731-3255
(920) 731-3357

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary

Other

Enumeration date
03/23/2010
Last updated
06/08/2010
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