| Genesis Lifestyle Medicine | |
|
1553 W Oak St Zionsville IN 46077-1840 | |
| (760) 835-8962 | |
| Not Available |
| Full Name | Genesis Lifestyle Medicine |
|---|---|
| Speciality | Family Medicine |
| Location | 1553 W Oak St, Zionsville, Indiana |
| Authorized Official Name and Position | Alex Spinoso (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 7258673337 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Genesis Lifestyle Medicine 1553 W Oak St Zionsville IN 46077-1840 Ph: (760) 835-8962 | Genesis Lifestyle Medicine 1553 W Oak St Zionsville IN 46077-1840 Ph: (760) 835-8962 |
| NPI Number | 1417556465 |
|---|---|
| Provider Enumeration Date | 10/21/2020 |
| Last Update Date | 02/08/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417556465 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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