Organization
THE GENESIS COMPANY, LLC
Active
Other names
Genesis Laser and Vein Center
Organization subpart
No
Provider details
NPI number
Authorized official
CHANDRA NATH PRASAD MD (OWNER)
(573) 761-5277
Entity
Organization
Contact information
Practice address
2511 W EDGEWOOD DR STE H, JEFFERSON CITY, MO 65109-5869
(573) 761-5277
Mailing address
2511 W EDGEWOOD DR STE H, JEFFERSON CITY, MO 65109-5869
(573) 761-5277
Taxonomy
Speciality
Code
Description
License number
State
202K00000X
Phlebology Physician
Primary
—
—
Other
Enumeration date
12/20/2017
Last updated
06/16/2018
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