Organization
BLUE LOTUS WELLNESS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARGARET BARNETT LATHAM DPT (OWNER)
(407) 614-5061
Entity
Organization
Contact information
Practice address
368 MOORE RD, OCOEE, FL 34761-4871
(407) 614-5061
Mailing address
368 MOORE RD, OCOEE, FL 34761-4871
(407) 614-5061
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
225200000X
Physical Therapy Assistant
—
—
225X00000X
Occupational Therapist
—
—
225XP0019X
Physical Rehabilitation Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
261Q00000X
Clinic/Center
—
—
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
107783400
—
FL
Enumeration date
04/21/2020
Last updated
10/20/2020
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