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General NPI Number Information
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NPI Number | 1588013551
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Entity Type | Organization
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Legal Business Name | PROGRESSIVEHEALTH, LLC
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Dates
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Enumeration Date | 06/09/2016
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Last Update Date | 06/09/2016
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Provider Practice Location Address
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Address Line | 1 LONE STAR PASS
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City | SAN ANTONIO
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State | TX
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Zip | 78264-3638
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Country | US
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Telephone | 210-263-5754
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 6890
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City | EVANSVILLE
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State | IN
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Zip | 47719-0890
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | KEITH BERSCH
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Credential |
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Telephone | 812-491-3856
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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