Provider Demographics
NPI:1184926826
Name:SACRED LOTUS ACUPUNCTURE, LLC
Entity type:Organization
Organization Name:SACRED LOTUS ACUPUNCTURE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:E
Authorized Official - Last Name:YEH
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:703-639-0900
Mailing Address - Street 1:2106 GALLOWS RD STE E2
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-3961
Mailing Address - Country:US
Mailing Address - Phone:703-639-0900
Mailing Address - Fax:
Practice Address - Street 1:2106 GALLOWS RD STE E2
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22182-3961
Practice Address - Country:US
Practice Address - Phone:703-639-0900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-01
Last Update Date:2014-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty