Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Health Source Physical Therapy Center, Inc

Organization Physical Therapy Clinic/Center · NPI 1083624969

Health Source Physical Therapy Center, Inc is a Physical Therapy Clinic/Center in Portland, Michigan. Licensed in Michigan. Registered with an NPI since 2006.

Licensed in
MI
In the registry since
2006
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1447 E Grand River Ave
Portland, MI 48875-1631
Phone: (517) 647-1000
Fax: (517) 647-1100
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapy Clinic/Center (primary) Taxonomy 261QP2000X · Licence 5501005495 (MI)

Record details

NPI number1083624969
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jaya Boddu — President · (517) 647-1000
NPI enumeratedAugust 9, 2006
Last updated in NPPESDecember 20, 2011
Mailing address1447 E Grand River Ave, Portland, MI 48875-1631