Organization
GENESIS HEALTH SYSTEM
Active
Other names
Genesis Pediatric Physical Therapy Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MARK G. ROGERS (CFO)
(563) 421-6513
Entity
Organization
Contact information
Practice address
2451 CORAL CT, SUITE 1, CORALVILLE, IA 52241-2837
(563) 421-9580
Mailing address
865 LINCOLN RD, SUITE L10, BETTENDORF, IA 52722-4190
(563) 355-9200
(563) 355-3419
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
11/03/2010
Last updated
11/03/2010
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