| Genesis Renewal, Inc. | |
|
12810 S Memorial Dr Unit 307 Bixby OK 74008-5506 | |
| (918) 685-2896 | |
| Not Available |
| Full Name | Genesis Renewal, Inc. |
|---|---|
| Speciality | Clinic/center |
| Location | 12810 S Memorial Dr Unit 307, Bixby, Oklahoma |
| Authorized Official Name and Position | Rebecca B Williamson (OWNER) |
| Authorized Official Contact | 9186852896 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Genesis Renewal, Inc. 12810 S Memorial Dr Unit 307 Bixby OK 74008-5506 Ph: (918) 685-2896 | Genesis Renewal, Inc. 12810 S Memorial Dr Unit 307 Bixby OK 74008-5506 Ph: (918) 685-2896 |
| NPI Number | 1215567185 |
|---|---|
| Provider Enumeration Date | 01/20/2020 |
| Last Update Date | 01/13/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215567185 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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