Organization
THE GENESIS COMPANY, LLC
Active
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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