MEDICARE: PROGRESSIVE PHYSICAL THERAPY, LLC

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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1871078675
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PROGRESSIVE PHYSICAL THERAPY, LLC

Provider Business Mailing Address
First Line	:	PO BOX 392573
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15251-9500
Country	:	US
Telephone Number	:	724-343-4060
Fax Number	:	724-343-4069

Provider Business Practice Location Address
First Line	:	15825 SHADY GROVE RD STE 50
Second Line	:
City	:	ROCKVILLE
State	:	MD
Zip	:	20850-4061
Country	:	US
Telephone Number	:	301-987-0999
Fax Number	:	301-987-7123

Authorized Official
Title or Position	:	CREDENTIALING/CONTRACTING SPECIALIS
Name	:	LAUREN LAU
Credential	:
Telephone Number	:	247-989-4564

Provider Enumeration Date	:	09/27/2018
Last Update Date	:	01/10/2022

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Directions to “PROGRESSIVE PHYSICAL THERAPY, LLC ” Practice Location

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