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General NPI Number Information
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NPI Number | 1174630107
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Entity Type | Organization
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Legal Business Name | PROGRESS PHYSICAL THERAPY
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Dates
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Enumeration Date | 08/24/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 3633 HARDEN RD STE 101
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City | RALEIGH
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State | NC
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Zip | 27607-3369
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Country | US
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Telephone | 919-789-4459
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Fax | 919-789-8342
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Provider Business Mailing Address
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Address Line | 3633 HARDEN RD STE 101
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City | RALEIGH
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State | NC
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Zip | 27607-3369
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Country | US
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Telephone | 919-789-4459
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Fax | 919-789-8342
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. LORI VON ALTEN
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Credential | PT, ATC-L, CSCI, CPI
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Telephone | 919-789-4459
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251S0007X
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Taxonomy Name | Sports Physical Therapist
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License Number |
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License Number State |
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