Organization
KENBECK LLC
Active
Other names
THE LIGHT THERAPY INSTITUTE
Organization subpart
No
Provider details
NPI number
Authorized official
SOFIYA JOHNSON (PRESIDENT)
(954) 491-3103
Entity
Organization
Contact information
Practice address
4342 E TRADEWINDS AVE, LAUDERDALE BY THE SEA, FL 33308-5044
(954) 491-3103
(954) 491-3105
Mailing address
4342 E TRADEWINDS AVE, LAUDERDALE BY THE SEA, FL 33308-5044
(954) 491-3103
Taxonomy
Speciality
Code
Description
License number
State
170100000X
Ph.D. Medical Genetics
Primary
—
—
Other
Enumeration date
02/28/2007
Last updated
06/17/2008
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