Healthcare Provider Details
I. General information
NPI: 1780452995
Provider Name (Legal Business Name): PROGRESSIONS PHYSICAL THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/18/2023
Last Update Date: 03/24/2025
Certification Date: 03/24/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
64 HOBBS ST # 3
CONWAY NH
03818-6251
US
IV. Provider business mailing address
30 ALPINE PLACE DR UNIT 110
NORTH CONWAY NH
03860-5277
US
V. Phone/Fax
- Phone: 603-242-1035
- Fax:
- Phone: 641-351-8741
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QP2000X |
| Taxonomy | Physical Therapy Clinic/Center |
| License Number | |
| License Number State | |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name: DR.
EMMA
BARNES
RUNQUIST
Title or Position: OWNER
Credential: PT, DPT
Phone: 641-351-8741