Provider Demographics
NPI:1174260814
Name:PROGRESSIVE FEET LLC
Entity Type:Organization
Organization Name:PROGRESSIVE FEET LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:ARASH
Authorized Official - Middle Name:ARI
Authorized Official - Last Name:CHANGIZI
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:301-567-5005
Mailing Address - Street 1:6130 OXON HILL RD STE 305
Mailing Address - Street 2:
Mailing Address - City:OXON HILL
Mailing Address - State:MD
Mailing Address - Zip Code:20745-3168
Mailing Address - Country:US
Mailing Address - Phone:301-567-5005
Mailing Address - Fax:
Practice Address - Street 1:2296 OPITZ BLVD STE 510
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22191-3348
Practice Address - Country:US
Practice Address - Phone:571-285-4208
Practice Address - Fax:571-285-4240
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-15
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty