# LIFEBRIDGE SPORTS MEDICINE & REHABILITATION, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** SELECT MEDICAL
- **Other names:** Lifebridge Health Physical Therapy
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1164200325
- **Legal business name:** SELECT MEDICAL
- **Authorized official:** MICHAEL TARVIN (VICE PRESIDENT)
- **Authorized official phone:** (717) 972-1100

## Contact information

- **Practice address:** 41 MAGNA WAY STE 140, WESTMINSTER, MD 21157-3073
- **Practice address phone:** (443) 487-6614
- **Mailing address:** 4714 GETTYSBURG RD, MECHANICSBURG, PA 17055-4325

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0400X | Rehabilitation Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 09/19/2023
- **Last updated:** 09/19/2023