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Organization

LIFEBRIDGE COMMUNITY PRACTICE

Active
Other names
Clinical Associates Specialist
Organization subpart
No

Provider details

NPI number
Authorized official
GRAYSON MICHAEL FOSTER (COO)
(410) 296-5300
Entity
Organization

Contact information

Practice address
750 MAIN ST, STE. 202, REISTERSTOWN, MD 21136-2515
(410) 526-3048
(410) 526-3062
Mailing address
750 MAIN ST, STE. 202, REISTERSTOWN, MD 21136-2515
(410) 526-3048
(410) 526-3062

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
MD

Other

Enumeration date
04/09/2014
Last updated
04/09/2014
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