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General NPI Number Information
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NPI Number | 1629394135
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Entity Type | Organization
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Legal Business Name | LOTUS CENTER OF HEALING, LLC
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Dates
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Enumeration Date | 04/09/2010
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Last Update Date | 07/22/2010
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Provider Practice Location Address
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Address Line | 1420 3RD ST N
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City | JACKSONVILLE BEACH
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State | FL
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Zip | 32250-7350
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Country | US
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Telephone | 904-616-4934
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Fax |
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Provider Business Mailing Address
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Address Line | 12716 COOL WATER WAY
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City | JACKSONVILLE
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State | FL
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Zip | 32246-5135
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | JOY ESLER
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Credential | A.P.
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Telephone | 904-616-4934
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AP2765
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License Number State | FL
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