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General NPI Number Information
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NPI Number | 1134718257
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Entity Type | Organization
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Legal Business Name | PROGRESSIVE REHABILITATIVE SERVICES, PLLC
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Dates
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Enumeration Date | 01/13/2021
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Last Update Date | 04/29/2021
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Provider Practice Location Address
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Address Line | 4313 S PLEASANT CROSSING BLVD
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City | ROGERS
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State | AR
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Zip | 72758-1347
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Country | US
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Telephone | 870-424-3181
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Fax | 870-424-3089
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Provider Business Mailing Address
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Address Line | 860 HIGHWAY 62 E STE 10
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City | MOUNTAIN HOME
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State | AR
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Zip | 72653-3200
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Country | US
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Telephone | 870-424-3181
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Fax | 870-424-3089
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | JOHN MICHAEL HARDIN
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Credential | DO
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Telephone | 870-424-3181
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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