Healthcare Provider Details

I. General information

NPI: 1386625051
Provider Name (Legal Business Name): PROGRESS IN MOTION, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2005
Last Update Date: 09/26/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

149 RAYMOND HIRSCH PKWY SUITE # 1
WHITE HOUSE TN
37188-4332
US

IV. Provider business mailing address

PO BOX 9
WHITE HOUSE TN
37188-0009
US

V. Phone/Fax

Practice location:
  • Phone: 615-672-2977
  • Fax: 615-672-2979
Mailing address:
  • Phone: 615-672-2977
  • Fax: 615-672-2979

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: MR. DANIEL WILSON HEADRICK
Title or Position: PRESIDENT
Credential: PHYSICAL THERAPIST
Phone: 615-672-2977