MEDICARE: PROGRESSIVE PHYSICAL THERAPY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1821375221
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PROGRESSIVE PHYSICAL THERAPY

Provider Business Mailing Address
First Line	:	1508 HESS ST
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43212-2679
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1508 HESS ST
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43212-2679
Country	:	US
Telephone Number	:	740-412-3457
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JAMES M KRUPAR
Credential	:	PT
Telephone Number	:	740-412-3457

Provider Enumeration Date	:	11/14/2011
Last Update Date	:	04/03/2012

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Directions to “PROGRESSIVE PHYSICAL THERAPY ” Practice Location

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