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Organization

LED LIFE, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BERGINA ISBELL (CHIEF MEDICAL OFFICER)
(507) 533-5441
Entity
Organization

Contact information

Practice address
3505 ELLICOTT MILLS DR STE A2, ELLICOTT CITY, MD 21043-4578
(507) 533-5433
Mailing address
PO BOX 6500, COLUMBIA, MD 21045-6500
(507) 533-5433

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary

Other

Enumeration date
09/25/2020
Last updated
05/20/2024
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