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General NPI Number Information
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NPI Number | 1376535781
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Entity Type | Organization
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Legal Business Name | PROGRESSIVE HEALTH AND REHAB CORP
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Dates
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Enumeration Date | 08/22/2005
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Last Update Date | 12/28/2018
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Provider Practice Location Address
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Address Line | 358 S HAMILTON RD SUITE B
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City | GAHANNA
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State | OH
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Zip | 43230-3311
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Country | US
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Telephone | 614-471-5442
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Fax | 614-471-5462
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Provider Business Mailing Address
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Address Line | 358 S HAMILTON RD SUITE B
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City | GAHANNA
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State | OH
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Zip | 43230-3311
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Country | US
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Telephone | 614-471-5442
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Fax | 614-471-5462
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ANTHONY CHARLES YANNESSA
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Credential | D.C.
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Telephone | 614-471-5442
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NN0400X
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Taxonomy Name | Neurology Chiropractor
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License Number | 2080
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT10430
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | 34004565
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License Number State | OH
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