Organization
PROGENIC REHAB, INC.
Active
Organization
PROGENIC REHAB, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS RICHARD LANGE MPT (PRESIDENT/CEO)
(954) 980-8364
Entity
Organization
Contact information
Practice address
9570 SW 107TH AVE STE 201C, MIAMI, FL 33176-2791
(954) 980-8364
(786) 542-1142
Mailing address
9570 SW 107TH AVE STE 201C, MIAMI, FL 33176-2791
(954) 980-8364
(786) 542-1142
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
PT18592
FL
Other
Enumeration date
12/12/2016
Last updated
12/12/2016
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