Organization
GENESIS HEALTH SYSTEM
Active
Other names
Genesis Medical Center - Physical Medicine and Rehabilitation
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK G. ROGERS (VICE PRESIDENT OF FINANCE)
(563) 421-6513
Entity
Organization
Contact information
Practice address
1351 W CENTRAL PARK AVE, 420, DAVENPORT, IA 52804-1853
(563) 421-4380
(563) 421-4389
Mailing address
PO BOX 310102, DES MOINES, IA 50331-0001
(563) 421-4380
(563) 421-4389
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0401944
—
IA
Enumeration date
05/17/2006
Last updated
04/27/2009
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