Organization Name: | PROGRESSIVE THERAPY CLINIC |
NPI Number: | 1598954265 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | WENDA JEANNE MERZ (OWNER) |
Mailing Address: | 9267 Greenback Ln Suite C-2 Orangevale |
State: | CA US |
Postal Code: | 956624863 |
Phone Number: | 9169882359 |
Fax Number: | 9169882359 |
NPI Enumeration Date: | 10/18/2007 |
NPI Last Update Date: | 10/18/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2000X |
License Number: | 7738 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Physical Therapy |
Taxonomy Definition: |