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General NPI Number Information
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NPI Number | 1871588624
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Entity Type | Organization
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Legal Business Name | PROGRESSIVE PHYSICAL THERAPY CENTER INC
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Dates
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Enumeration Date | 09/19/2005
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Last Update Date | 06/09/2015
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Provider Practice Location Address
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Address Line | 12651 S DIXIE HWY SUITE 205
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City | MIAMI
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State | FL
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Zip | 33156-5975
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Country | US
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Telephone | 305-232-9222
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Fax | 305-232-8808
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Provider Business Mailing Address
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Address Line | 12651 S DIXIE HWY SUITE 205
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City | MIAMI
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State | FL
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Zip | 33156-5975
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Country | US
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Telephone | 305-232-9222
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Fax | 305-232-8808
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Authorized Official
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Title or Position | OWNER
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Name | GREGORY WELCH
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Credential | PT
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Telephone | 305-232-9222
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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 | PT9372, PT8934
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License Number State | FL
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