Organization
SOURCE ONE REHABILITATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JARROD ROGERS PRES (PRESIDENT)
(214) 577-9191
Entity
Organization
Contact information
Practice address
5425 W SPRING CREEK PKWY, SUITE 130, PLANO, TX 75024-4236
(972) 801-2190
(972) 801-2191
Mailing address
PO BOX 25006, FORT WORTH, TX 76124-2006
(972) 801-2190
(972) 801-2191
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
TX
Other
Enumeration date
10/31/2007
Last updated
10/31/2007
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