Organization
THERAPY SOURCE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA INGUI (SENIOR CREDENTIALING SPECIALIST)
(484) 342-2000
Entity
Organization
Contact information
Practice address
2650 GRINDLEY PARK, DEARBORN, MI 48124
(507) 219-1079
Mailing address
2650 GRINDLEY PARK, DEARBORN, MI 48124
(507) 219-1079
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
6801092718
MI
Other
Enumeration date
11/24/2015
Last updated
11/24/2015
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