MEDICARE: LOTUS CHIROPRACTIC CARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QH0100X	Health Service Clinic/Center	CHIR009447	GA

General Provider Information

NPI Number	:	1093109274
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LOTUS CHIROPRACTIC CARE LLC

Provider Business Mailing Address
First Line	:	2150 BRYANT POINTE DR
Second Line	:
City	:	MARIETTA
State	:	GA
Zip	:	30066-4699
Country	:	US
Telephone Number	:	404-509-5524
Fax Number	:

Provider Business Practice Location Address
First Line	:	1730 MOUNT VERNON RD STE C
Second Line	:
City	:	DUNWOODY
State	:	GA
Zip	:	30338-4245
Country	:	US
Telephone Number	:	470-719-9539
Fax Number	:

Authorized Official
Title or Position	:	PRIMARY
Name	:	TANVI DESAI
Credential	:	DC
Telephone Number	:	404-719-9539

Provider Enumeration Date	:	03/25/2015
Last Update Date	:	09/18/2025

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