Provider Demographics
NPI:1649204231
Name:PROGRESSIVE PHYSICAL THERAPY PC
Entity Type:Organization
Organization Name:PROGRESSIVE PHYSICAL THERAPY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT CEO
Authorized Official - Prefix:
Authorized Official - First Name:BELINDA
Authorized Official - Middle Name:J
Authorized Official - Last Name:HAYS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:812-522-7887
Mailing Address - Street 1:PO BOX 1192
Mailing Address - Street 2:321 W BRUCE STREET STE B
Mailing Address - City:SEYMOUR
Mailing Address - State:IN
Mailing Address - Zip Code:47274
Mailing Address - Country:US
Mailing Address - Phone:812-522-7887
Mailing Address - Fax:812-522-7326
Practice Address - Street 1:321 W BRUCE STREET
Practice Address - Street 2:STE B
Practice Address - City:SEYMOUR
Practice Address - State:IN
Practice Address - Zip Code:47274
Practice Address - Country:US
Practice Address - Phone:812-522-7887
Practice Address - Fax:812-522-7326
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2013-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN53000010A261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100140690Medicaid
IN156563Medicare Oscar/Certification