Organization
LIFEBRIDGE SPORTS MEDICINE & REHABILITATION, LLC
Active
Parent organization
SELECT MEDICAL
Organization subpart
Yes
Provider details
NPI number
Legal business name
SELECT MEDICAL
Authorized official
MICHAEL TARVIN (VICE PRESIDENT)
(717) 972-1100
Entity
Organization
Contact information
Practice address
41 MAGNA WAY STE 140, WESTMINSTER, MD 21157-3073
(443) 487-6614
Mailing address
4714 GETTYSBURG RD, MECHANICSBURG, PA 17055-4325
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
09/15/2023
Last updated
09/15/2023
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