Provider Demographics
NPI:1396200952
Name:GENESIS PHYSICAL THERAPY & WELLNESS, INC
Entity Type:Organization
Organization Name:GENESIS PHYSICAL THERAPY & WELLNESS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ROBBIE
Authorized Official - Middle Name:
Authorized Official - Last Name:LYNCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-586-6594
Mailing Address - Street 1:1088 MACDONALD LAKE RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35146-3853
Mailing Address - Country:US
Mailing Address - Phone:205-586-6594
Mailing Address - Fax:
Practice Address - Street 1:2020 CANYON RD STE 200
Practice Address - Street 2:
Practice Address - City:VESTAVIA HILLS
Practice Address - State:AL
Practice Address - Zip Code:35216-1959
Practice Address - Country:US
Practice Address - Phone:205-423-0894
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-07
Last Update Date:2019-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy