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General NPI Number Information
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NPI Number | 1912936840
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Entity Type | Organization
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Legal Business Name | PROGRESSIVE PHYSICAL THERAPY AND REHABILITATION INC
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Dates
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Enumeration Date | 07/02/2006
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Last Update Date | 08/01/2011
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Provider Practice Location Address
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Address Line | 7461 GARDEN GROVE BLVD SUITE A
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City | GARDEN GROVE
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State | CA
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Zip | 92841
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Country | US
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Telephone | 714-379-4510
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Fax | 714-379-4509
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Provider Business Mailing Address
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Address Line | 7461 GARDEN GROVE BLVD SUITE A
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City | GARDEN GROVE
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State | CA
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Zip | 92841
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Country | US
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Telephone | 714-379-4510
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Fax | 714-379-4509
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Authorized Official
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Title or Position | OWNER
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Name | MR. MICHAEL KENNETH MCKINDLEY
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Credential | PT
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Telephone | 714-379-4510
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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 | PT13058
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License Number State | CA
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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 | PT25272
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License Number State | CA
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