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General NPI Number Information
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NPI Number | 1265068829
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Entity Type | Organization
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Legal Business Name | LOTUS INTEGRATIVE THERAPY LLC
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Dates
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Enumeration Date | 03/16/2020
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Last Update Date | 03/16/2020
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Provider Practice Location Address
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Address Line | 3814 WEST STREET SUITE #112 LOTUS INTEGRATIVE THERAPY
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City | MARLEMONT
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State | OH
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Zip | 45227
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Country | US
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Telephone | 773-259-4786
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Fax | 513-327-2036
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Provider Business Mailing Address
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Address Line | 3814 WEST STREET SUITE #112 LOTUS INTEGRATIVE THERAPY
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City | MARLEMONT
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State | OH
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Zip | 45227
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Country | US
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Telephone | 773-259-4786
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Fax | 513-327-2036
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Authorized Official
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Title or Position | OWNER (ACUPUNCTURIST & OCCUPATIONAL
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Name | MRS. INGRID ELIZABETH KEATING
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Credential | L. AC., OTR/L
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Telephone | 773-259-4786
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225A00000X
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Taxonomy Name | Music Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number |
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License Number State |
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