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Organization
SOURCE PHYSIOTHERAPY LLC
Active
Organization
SOURCE PHYSIOTHERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EMMANNOUIL LAGOGIANNIS PT, MSC (PHYSIOTHERAPIST)
(443) 355-8891
Entity
Organization
Contact information
Practice address
10155 YORK RD STE 205-206, COCKEYSVILLE, MD 21030-3352
(443) 355-8891
Mailing address
14 HILLSYDE CT, COCKEYSVILLE, MD 21030-1750
(443) 355-8891
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
NULL
Other
Enumeration date
07/20/2021
Last updated
07/14/2024
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