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General NPI Number Information
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NPI Number | 1093450298
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Entity Type | Organization
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Legal Business Name | PINK LOTUS HEALING, INC
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Dates
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Enumeration Date | 05/02/2022
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Last Update Date | 05/02/2022
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Provider Practice Location Address
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Address Line | 112 ORANGE AVE STE 200
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City | DAYTONA BEACH
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State | FL
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Zip | 32114-4338
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Country | US
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Telephone | 386-898-4967
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Fax |
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Provider Business Mailing Address
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Address Line | 112 ORANGE AVE STE 200
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City | DAYTONA BEACH
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State | FL
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Zip | 32114-4338
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Country | US
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Telephone | 386-627-7777
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Fax |
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | CATHLEEN BELLEROSE
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Credential | LPN, CMT, MMT, MLD-C
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Telephone | 386-898-4967
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State |
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