Provider Demographics
NPI:1194426080
Name:LARKINS, GENESIS (DC)
Entity type:Individual
Prefix:DR
First Name:GENESIS
Middle Name:
Last Name:LARKINS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:GENESIS
Other - Middle Name:
Other - Last Name:HOLMES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:3973 S PEPPERTREE CT
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85297-0064
Mailing Address - Country:US
Mailing Address - Phone:336-398-4652
Mailing Address - Fax:
Practice Address - Street 1:21323 S ELLSWORTH LOOP RD STE 101
Practice Address - Street 2:
Practice Address - City:QUEEN CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85142-9865
Practice Address - Country:US
Practice Address - Phone:480-307-8440
Practice Address - Fax:480-307-8560
Is Sole Proprietor?:No
Enumeration Date:2023-03-16
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ9067111N00000X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor