Healthcare Provider Details

I. General information

NPI: 1225286891
Provider Name (Legal Business Name): PROGRESSIVE THERAPY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2008
Last Update Date: 09/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

206 WELCH CT.
LYONS CO
80540-0352
US

IV. Provider business mailing address

P.O. BOX 352
LYONS CO
80540-0352
US

V. Phone/Fax

Practice location:
  • Phone: 303-870-6030
  • Fax: 303-389-9404
Mailing address:
  • Phone: 303-870-6030
  • Fax: 303-389-9404

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LAURIE HARPER
Title or Position: PHYSICAL THERAPIST
Credential: B.S.
Phone: 303-870-6030