Provider Demographics
NPI:1265068829
Name:LOTUS INTEGRATIVE THERAPY LLC
Entity type:Organization
Organization Name:LOTUS INTEGRATIVE THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER (ACUPUNCTURIST & OCCUPATIONAL
Authorized Official - Prefix:MRS
Authorized Official - First Name:INGRID
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:KEATING
Authorized Official - Suffix:
Authorized Official - Credentials:L AC, OTR/L
Authorized Official - Phone:773-259-4786
Mailing Address - Street 1:3814 WEST STREET SUITE #112 LOTUS INTEGRATIVE THERAPY
Mailing Address - Street 2:
Mailing Address - City:MARLEMONT
Mailing Address - State:OH
Mailing Address - Zip Code:45227
Mailing Address - Country:US
Mailing Address - Phone:773-259-4786
Mailing Address - Fax:513-327-2036
Practice Address - Street 1:3814 WEST STREET SUITE #112 LOTUS INTEGRATIVE THERAPY
Practice Address - Street 2:
Practice Address - City:MARLEMONT
Practice Address - State:OH
Practice Address - Zip Code:45227
Practice Address - Country:US
Practice Address - Phone:773-259-4786
Practice Address - Fax:513-327-2036
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-16
Last Update Date:2020-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic TherapistGroup - Multi-Specialty