Provider Demographics
NPI:1619483005
Name:RED LOTUS SERVICES LLC
Entity Type:Organization
Organization Name:RED LOTUS SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDRIA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:D'AMATO
Authorized Official - Suffix:
Authorized Official - Credentials:DC, DABCA
Authorized Official - Phone:330-360-5918
Mailing Address - Street 1:45 MANOR HILL DR STE 300
Mailing Address - Street 2:
Mailing Address - City:CANFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44406-1538
Mailing Address - Country:US
Mailing Address - Phone:234-414-7130
Mailing Address - Fax:330-629-9339
Practice Address - Street 1:45 MANOR HILL DR STE 300
Practice Address - Street 2:
Practice Address - City:CANFIELD
Practice Address - State:OH
Practice Address - Zip Code:44406-1538
Practice Address - Country:US
Practice Address - Phone:234-414-7130
Practice Address - Fax:330-629-9339
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-20
Last Update Date:2017-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4072111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty