Provider Demographics
NPI:1396454500
Name:PROGRESSIVE PHYSICAL THERAPY, LLC
Entity type:Organization
Organization Name:PROGRESSIVE PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER OF 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:15251-9500
Mailing Address - Country:US
Mailing Address - Phone:724-343-4060
Mailing Address - Fax:
Practice Address - Street 1:8316 ARLINGTON BLVD STE 640
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-5216
Practice Address - Country:US
Practice Address - Phone:703-272-8340
Practice Address - Fax:703-272-8365
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PROGRESSIVE PHYSICAL THERAPY, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-11-16
Last Update Date:2022-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty