Organization
LIFEBRIDGE SPORTS MEDICINE AND REHABILITATION LLC
Active
Parent organization
LIFEBRIDGE SPORTS MEDICINE AND REHABILITATION LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
LIFEBRIDGE SPORTS MEDICINE AND REHABILITATION LLC
Authorized official
MICHAEL E TARVIN (VICE PRESIDENT)
(717) 972-1100
Entity
Organization
Contact information
Practice address
1393 PROGRESS WAY STE 907, ELDERSBURG, MD 21784-6473
(410) 549-4960
Mailing address
4714 GETTYSBURG RD, MECHANICSBURG, PA 17055-4325
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
06/20/2018
Last updated
06/20/2018
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