Provider Demographics
NPI:1598454423
Name:LOTUS ACUPUNCTURE AND CHINESE MEDICINE, LLC
Entity Type:Organization
Organization Name:LOTUS ACUPUNCTURE AND CHINESE MEDICINE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRANDY
Authorized Official - Middle Name:M
Authorized Official - Last Name:VALENTINE
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:539-250-9959
Mailing Address - Street 1:9717 E 42ND ST STE 130
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74146-3677
Mailing Address - Country:US
Mailing Address - Phone:918-703-0724
Mailing Address - Fax:918-928-3606
Practice Address - Street 1:9717 E 42ND ST STE 130
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74146-3677
Practice Address - Country:US
Practice Address - Phone:918-703-0724
Practice Address - Fax:918-928-3606
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-05
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty