Organization
GENESIS CHIROPRACTIC SPINE CTR
Active
Other names
Genesis Wellness Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
CLYDE JOHNSON DC- MS REHAB, MS-NUT (OWNER)
(720) 515-8002
Entity
Organization
Contact information
Practice address
5950 S WILLOW DR, SUITE 200, GREENWOOD VILLAGE, CO 80111-5170
(720) 515-8002
Mailing address
5950 S WILLOW DR, SUITE 200, GREENWOOD VILLAGE, CO 80111-5170
(720) 515-8002
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
EL.2786103
CO
261QP2300X
Primary Care Clinic/Center
Primary
CHR.0006922
CO
Other
Enumeration date
01/29/2015
Last updated
01/29/2015
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