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General NPI Number Information
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NPI Number | 1679104632
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Entity Type | Organization
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Legal Business Name | PROGRESSIVE PHYSICAL THERAPY, LLC
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Dates
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Enumeration Date | 01/29/2020
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Last Update Date | 01/10/2022
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Provider Practice Location Address
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Address Line | 901 N PITT ST STE 150
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City | ALEXANDRIA
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State | VA
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Zip | 22314-1564
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Country | US
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Telephone | 570-312-2294
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Fax | 571-982-4132
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Provider Business Mailing Address
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Address Line | PO BOX 392573
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City | PITTSBURGH
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State | PA
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Zip | 15251-9573
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Country | US
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Telephone | 724-343-4060
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Fax | 724-343-4069
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Authorized Official
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Title or Position | DIRECTOR OF CREDENTIALING
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Name | LAUREN LAU
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Credential |
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Telephone | 724-989-4564
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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