Organization
LOTUS INTEGRATED LONGEVITY ANTI-AGING CENTER, INC.
Active
Other names
L.I.L.A.C.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EPIFANIA CRUZ M.D. (MEDICAL DIRECTOR)
(856) 772-4971
Entity
Organization
Contact information
Practice address
2301 E EVESHAM RD, VOORHEES, NJ 08043-4501
(856) 772-4971
(856) 772-1140
Mailing address
2301 E EVESHAM RD, VOORHEES, NJ 08043-4501
(856) 772-4971
(856) 772-1140
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
25MA05996900
NJ
Other
Enumeration date
12/06/2013
Last updated
12/06/2013
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