| Organization Name: | PROGRESSIVE PHYSICAL AND SPORTS THERAPY LLC |
| NPI Number: | 1598036907 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | PATRICIA LEE TRACY (OWNER) |
| Mailing Address: | 1043 Wolfrum Rd Weldon Spring |
| State: | MO US |
| Postal Code: | 633047625 |
| Phone Number: | 6363004600 |
| Fax Number: | 6363004603 |
| NPI Enumeration Date: | 01/17/2012 |
| NPI Last Update Date: | 06/21/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2000X |
| License Number: | 01952 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Physical Therapy |
| Taxonomy Definition: | |