NPI 1427135045

Genesis Disc Institute

Organisation Exclusive Provider Organization Woodbury, MN

Practice location

Address: 8425 Seasons Pkwy STE 104b, Woodbury, MN 55125-5403
Phone: (651) 702-7800
Fax: (651) 702-7804

Authorised official

Name: David Mark Pietsch
Title: Owner
Phone: (651) 702-7800

Registered specialties

Exclusive Provider Organization Primary

Managed Care Organizations Taxonomy 302F00000X Licence 3581 (MN)

Other Exclusive Provider Organization providers in Minnesota →

Registry record

NPI: 1427135045
Entity type: Organization
NPI issued: 1 Nov 2006
Record last updated: 22 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.