Organization
LIFE LINE PARTNERS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KATHLEEN A BURGDORF (CEO)
(330) 759-9233
Entity
Organization
Contact information
Practice address
1825 TIBBETTS WICK RD, GIRARD, OH 44420-1222
(330) 759-9233
(330) 759-9677
Mailing address
PO BOX 119, GIRARD, OH 44420-0119
(330) 759-9233
(330) 759-9677
Taxonomy
Speciality
Code
Description
License number
State
2251C2600X
Cardiopulmonary Physical Therapist
Primary
PT009048
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000220269
ANTHEM
OH
05
—
2198643
—
OH
Enumeration date
07/05/2006
Last updated
08/26/2013
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