Healthcare Provider Details

I. General information

NPI: 1194565648
Provider Name (Legal Business Name): BLS DIAGNOSTICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2024
Last Update Date: 04/17/2026
Certification Date: 04/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

915 TOLL HOUSE AVE STE 307
FREDERICK MD
21701-5901
US

IV. Provider business mailing address

2012 S TOLLGATE RD STE 100
BEL AIR MD
21015-5901
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 TaxonomyN
Taxonomy Code2251E1300X
TaxonomyClinical Electrophysiology Physical Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2084N0600X
TaxonomyClinical Neurophysiology Physician
License Number
License Number State

VIII. Authorized Official

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