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Organization
PROGRESS PHYSICAL THERAPY INC
Active
Organization
PROGRESS PHYSICAL THERAPY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SHIVAKUMAR SUBBARAYAN RPT (PRESIDENT)
(989) 728-0242
Entity
Organization
Contact information
Practice address
3076 NORTHRIDGE RD, HALE, MI 48739-9277
(989) 728-0242
(989) 728-1144
Mailing address
3076 NORTHRIDGE RD, HALE, MI 48739-9277
(989) 728-0242
(989) 728-1144
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501008794
MI
261QP2000X
Physical Therapy Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4621772
—
MI
01
—
650F510260
BCBSM
MI
Enumeration date
10/26/2005
Last updated
02/05/2025
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