Organization Name: | PROGRESSIVE SPINE CARE & REHABILITATION CLINIC |
NPI Number: | 1205935103 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | BRENDA L WOODS (OWNER/PRESIDENT) |
Mailing Address: | 3301 Berrywood Dr Suite #101 Columbia |
State: | MO US |
Postal Code: | 652016517 |
Phone Number: | 5734422442 |
Fax Number: | 5736343146 |
NPI Enumeration Date: | 09/21/2006 |
NPI Last Update Date: | 01/29/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | R8F94 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |