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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