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Organization

AESTHETICS & BODY LAB

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KEISHA BERNARD NP (OWNER)
(240) 328-2015
Entity
Organization

Contact information

Practice address
9650 SANTIAGO RD STE 7, COLUMBIA, MD 21045-3960
(301) 309-7307
(301) 238-8039
Mailing address
9650 SANTIAGO RD STE 7, COLUMBIA, MD 21045-3960
(301) 309-7307
(301) 238-8039

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary

Other

Enumeration date
02/12/2024
Last updated
02/12/2024
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