Provider Demographics
NPI:1558992404
Name:PROGRESSIVE PHYSICAL THERAPY, LLC
Entity Type:Organization
Organization Name:PROGRESSIVE PHYSICAL THERAPY, LLC
Other - Org Name:PHOENIX REHABILITATION AND HEALTH SERVICES, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SR CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:
Authorized Official - Last Name:METAL-CONFER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-448-2733
Mailing Address - Street 1:PO BOX 392573
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15251-9573
Mailing Address - Country:US
Mailing Address - Phone:724-343-4060
Mailing Address - Fax:724-343-4069
Practice Address - Street 1:6410 DOBBIN RD STE G
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-4774
Practice Address - Country:US
Practice Address - Phone:443-917-2951
Practice Address - Fax:443-864-5296
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PHOENIX REHABILITATION AND HEALTH SERVICES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-01-30
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty