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General NPI Number Information
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NPI Number | 1740474972
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Entity Type | Organization
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Legal Business Name | LIFELINE PARTNERS, INC
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Dates
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Enumeration Date | 08/30/2007
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Last Update Date | 08/30/2007
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Provider Practice Location Address
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Address Line | 250 DEBARTOLO PL SUITE 1535
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City | BOARDMAN
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State | OH
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Zip | 44512-7004
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Country | US
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Telephone | 330-759-5981
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Fax | 330-759-9677
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Provider Business Mailing Address
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Address Line | PO BOX 8005
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City | YOUNGSTOWN
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State | OH
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Zip | 44505-8005
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Country | US
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Telephone | 330-759-5981
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Fax | 330-759-9677
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Authorized Official
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Title or Position | VP
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Name | MR. BRUCE BURGDORF
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Credential |
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Telephone | 330-759-5981
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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