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Organization

BODHI LOTUS, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. MICHELLE JENNIFER NEWKIRK LPN (PRESIDENT)
(585) 797-5259
Entity
Organization

Contact information

Practice address
61 MARSHALL ST, #1, ROCHESTER, NY 14607-3523
(585) 797-5259
Mailing address
61 MARSHALL ST, #1, ROCHESTER, NY 14607-3523
(585) 797-5259

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary

Other

Enumeration date
09/23/2009
Last updated
09/23/2009
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