Organization
PROGRESSIVE PHYSICAL THERAPY INC
Active
Organization
PROGRESSIVE PHYSICAL THERAPY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES LAWRENCE PIAZZA JR. DPT, ATC, MTC (PHYSICAL THERAPIST, PRESIDENT)
(386) 898-0443
Entity
Organization
Contact information
Practice address
290 CLYDE MORRIS BLVD, SUITE B-2, ORMOND BEACH, FL 32174-8130
(386) 898-0443
(386) 898-0459
Mailing address
290 CLYDE MORRIS BLVD, SUITE B-2, ORMOND BEACH, FL 32174-8130
(386) 898-0443
(386) 898-0459
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
HCC5366
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6457550001
PTAN
FL
Enumeration date
11/13/2006
Last updated
01/19/2011
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