Organization
LEOTA LIFESTAR LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SANDRA E MARLEY (VICE PRESIDENT)
(240) 405-6865
Entity
Organization
Contact information
Practice address
75 THOMAS JOHNSON DR, SUITE E, FREDERICK, MD 21702-4895
(240) 405-9059
(443) 283-4038
Mailing address
75 THOMAS JOHNSON DR, SUITE E, FREDERICK, MD 21702-4895
(240) 405-9059
(443) 283-4038
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
06/07/2010
Last updated
06/07/2010
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