Provider Demographics
NPI:1285002493
Name:PROGRESSIVE SPINE AND INJURY CENTER
Entity Type:Organization
Organization Name:PROGRESSIVE SPINE AND INJURY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:KREGER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:401-615-7545
Mailing Address - Street 1:88 W WARWICK AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:WEST WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02893-3871
Mailing Address - Country:US
Mailing Address - Phone:401-615-7545
Mailing Address - Fax:401-615-7546
Practice Address - Street 1:88 W WARWICK AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:WEST WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02893-3871
Practice Address - Country:US
Practice Address - Phone:401-615-7545
Practice Address - Fax:401-615-7546
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-03
Last Update Date:2015-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedicGroup - Single Specialty
No111NN1001XChiropractic ProvidersChiropractorNutritionGroup - Single Specialty