Healthcare Provider Details

I. General information

NPI: 1235041088
Provider Name (Legal Business Name): PROGRESS PHYSICAL THERAPY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

990 PLEASANT ST
BROCKTON MA
02301-3063
US

IV. Provider business mailing address

990 PLEASANT ST
BROCKTON MA
02301-3063
US

V. Phone/Fax

Practice location:
  • Phone: 508-258-2227
  • Fax: 508-449-0442
Mailing address:
  • Phone: 508-258-2777
  • Fax: 508-449-0442

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: EVANDRA AGUIAR
Title or Position: OWNER
Credential:
Phone: 508-989-1330