Provider Demographics
NPI:1710686902
Name:LOTT, JULIE MACH (LAC , DIP OM)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:MACH
Last Name:LOTT
Suffix:
Gender:F
Credentials:LAC , DIP OM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:308 ARREZO LN
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78628-7072
Mailing Address - Country:US
Mailing Address - Phone:254-220-1101
Mailing Address - Fax:
Practice Address - Street 1:212 W 10TH ST
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78626-5814
Practice Address - Country:US
Practice Address - Phone:512-943-9885
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-27
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist