Provider Demographics
NPI:1881289684
Name:GENELIN, MOLLY (DC)
Entity type:Individual
Prefix:
First Name:MOLLY
Middle Name:
Last Name:GENELIN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:280 S JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:COOKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38501-3453
Mailing Address - Country:US
Mailing Address - Phone:931-528-5284
Mailing Address - Fax:931-520-1870
Practice Address - Street 1:280 S JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38501-3453
Practice Address - Country:US
Practice Address - Phone:931-528-5284
Practice Address - Fax:931-520-1870
Is Sole Proprietor?:No
Enumeration Date:2021-03-03
Last Update Date:2021-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3364111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor