Healthcare Provider Details

I. General information

NPI: 1164152419
Provider Name (Legal Business Name): BLS DIAGNOSTICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2022
Last Update Date: 01/28/2026
Certification Date: 01/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6816 DEERPATH RD STE 201
ELKRIDGE MD
21075-7392
US

IV. Provider business mailing address

7600 OSLER DR STE 105
TOWSON MD
21204-7705
US

V. Phone/Fax

Practice location:
  • Phone: 866-526-8088
  • Fax: 866-526-8080
Mailing address:
  • Phone: 866-526-8088
  • Fax: 866-526-8080

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: BRIAN L SEYMORE
Title or Position: OWNER/PT
Credential:
Phone: 866-526-8088