Source Physical Therapy LLC

NPI #1962593871 in Gig Harbor, Washington

Provider Information

NPI Number: 1962593871
Entity Type: Organization
Organization Name: Source Physical Therapy LLC
Primary Specialty: Physical Therapist
Enumeration Date: Sep 27, 2006
Last Updated: Sep 30, 2014

Practice Location

Address: 6659 KIMBALL DR
Address 2: SUITE A101
City: Gig Harbor
State: Washington
ZIP Code: 98335-5137
Phone: (253) 857-4870

Authorized Official

Name: DANA CARNAHAN, PT
Title: OWNER
Phone: (253) 857-4870

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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