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Organization
PROGRESSIVE REHAB CARE, LLC
Active
Organization
PROGRESSIVE REHAB CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SANJAY KHETARPAL (MEMBER MANAGER)
(910) 814-1555
Entity
Organization
Contact information
Practice address
1901 N MAIN ST, LILLINGTON, NC 27546-6824
(910) 814-1555
(910) 814-1556
Mailing address
PO BOX 629, MAULDIN, SC 29662-0629
(910) 814-1555
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7211831
—
NC
Enumeration date
01/09/2006
Last updated
07/11/2007
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