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Organization
SOURCE LINGUISTICS PHYSICAL THERAPY -REHABILITATION CENTER
Active
Organization
SOURCE LINGUISTICS PHYSICAL THERAPY -REHABILITATION CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HARRY L MONTGOMERY (ADMINISTRATOR)
(843) 206-9325
Entity
Organization
Contact information
Practice address
111 N MATTHEWS RD, LAKE CITY, SC 29560-2309
(843) 394-5618
(843) 394-5618
Mailing address
1125 ELMGROVE AVE, FLORENCE, SC 29506-6312
(843) 206-9325
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1581
SC
Other
Enumeration date
07/29/2018
Last updated
07/24/2019
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