# LIFEBRIDGE SPORTS MEDICINE AND REHABILITATION LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1770059701
- **Authorized official:** ELIZABETH GELBAUGH (MANAGER)
- **Authorized official phone:** (717) 972-1100

## Contact information

- **Practice address:** 19 WALKER AVE STE 100, PIKESVILLE, MD 21208-4006
- **Practice address phone:** (410) 484-2855
- **Mailing address:** 4714 GETTYSBURG RD, MECHANICSBURG, PA 17055-4325

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | NULL | Yes |
| 225100000X | Physical Therapist | — | — | Yes |
| 225X00000X | Occupational Therapist | — | NULL | — |
| 225X00000X | Occupational Therapist | — | — | — |
| 261Q00000X | Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 10/17/2018
- **Last updated:** 10/17/2018