Organization
PROGRESSIVE PEDIATRIC REHAB, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PATRICIA A. MILLER MSP, CCC-SLP (SPEECH LANGUAGE PATHOLOGIST)
(803) 649-0981
Entity
Organization
Contact information
Practice address
6250 WOODSIDE EXECUTIVE CT, AIKEN, SC 29803-3822
(803) 649-0981
Mailing address
PO BOX 7144, AIKEN, SC 29804-7144
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3111
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SA0380
—
SC
Enumeration date
06/14/2008
Last updated
06/14/2008
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