Healthcare Provider Details
I. General information
NPI: 1497343966
Provider Name (Legal Business Name): BLS DIAGNOSTICS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/09/2021
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
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
- Phone: 866-526-8088
- Fax: 866-526-8080
- Phone: 866-526-8088
- Fax: 866-526-8080
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2251E1300X |
| Taxonomy | Clinical Electrophysiology Physical Therapist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084N0400X |
| Taxonomy | Neurology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
BRIAN
L
SEYMORE
Title or Position: PRINCIPLE
Credential: DC, PT, DIBE, DABCE
Phone: 866-526-8088