Organization
LIFEBRIDGE SPORTS MEDICINE AND REHABILITATION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL TARVIN (VICE PRESIDENT)
(717) 972-1100
Entity
Organization
Contact information
Practice address
6190 GEORGETOWN BLVD, ELDERSBURG, MD 21784-6460
(410) 552-4235
Mailing address
4714 GETTYSBURG RD, MECHANICSBURG, PA 17055-4325
(717) 972-1100
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
08/03/2020
Last updated
08/03/2020
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