NPI 1174856645

Lifebridge Investments

Organisation Optometrist Reisterstown, MD

Practice location

Address: 750 Main St Suite 301a, Reisterstown, MD 21136-2515
Phone: (410) 526-3060
Fax: (410) 526-3091
Mailing address: 2401 W Belvedere Ave Credentialing, Baltimore, MD 21215-5216

Authorised official

Name: Suzanne Beasley Thomas
Title: Director
Phone: (410) 494-1212

Registered specialties

Optometrist Primary

Eye and Vision Services Providers Taxonomy 152W00000X Licence TA1490 (MD)

Other Optometrist providers in Maryland →

Registry record

NPI: 1174856645
Entity type: Organization
NPI issued: 15 Sep 2009
Record last updated: 8 Sep 2010

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.