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General NPI Number Information
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NPI Number | 1346545449
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Entity Type | Organization
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Legal Business Name | BLUE LOTUS HEALING ARTS, LLC
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Dates
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Enumeration Date | 01/20/2011
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Last Update Date | 01/20/2011
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Provider Practice Location Address
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Address Line | 2720 E 50TH ST
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City | MINNEAPOLIS
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State | MN
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Zip | 55417-1337
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Country | US
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Telephone | 612-721-0036
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Fax |
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Provider Business Mailing Address
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Address Line | 2720 E 50TH ST
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City | MINNEAPOLIS
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State | MN
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Zip | 55417-1337
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Country | US
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Telephone | 612-721-0036
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF PROGRAMS
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Name | MR. BENJAMIN HERSCHEL KATZ
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Credential | CMT
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Telephone | 612-590-1443
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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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Taxonomy #2
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 1518
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License Number State | MN
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