Contract Details
Lifebridge Sports Medicine & Rehabilitation, LLC
Facility name
Lifebridge Sports Medicine & Rehabilitation, LLC
Provider ID
P000002230
NPI
1467730572
Tax ID
382617193
Effective Date
7/21/2011
Last Updated
4/12/2018
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
10 Warren Rd Suite 220
Cockeysville, MD 210302531
United States
County
Baltimore
Phone
4106287330 (Phone)
Billing Details
Address
PO Box 636002
Littleton, CO 801636002
Billing Phone
3036942295
Specialty Type
Physical Therapy
Map
Address