Organization
SOURCE ONE THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM GARRET HARRELL (COO)
(972) 801-2190
Entity
Organization
Contact information
Practice address
5425 W SPRING CREEK PKWY, SUITE 270, PLANO, TX 75024-4236
(817) 291-1460
Mailing address
PO BOX 251728, PLANO, TX 75025-1517
(972) 801-2190
(972) 801-2191
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
11/05/2015
Last updated
03/24/2022
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