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General NPI Number Information
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NPI Number | 1144419078
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Entity Type | Organization
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Legal Business Name | PROGRESSIVE HOME WOUND CARE, INC
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Dates
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Enumeration Date | 10/16/2007
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Last Update Date | 10/21/2024
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Provider Practice Location Address
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Address Line | 1634 AVENUE OF THE CITIES STE D
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City | MOLINE
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State | IL
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Zip | 61265-4860
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Country | US
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Telephone | 309-762-9711
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Fax | 309-764-0553
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Provider Business Mailing Address
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Address Line | 1634 AVENUE OF THE CITIES STE D
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City | MOLINE
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State | IL
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Zip | 61265-4860
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Country | US
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Telephone | 309-737-5826
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | RODNEY C HOWELL
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Credential | APN
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Telephone | 309-737-5286
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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