Organization
PROGRESSIVE BEGINNINGS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN L ELMENDORF III OTR (OWNER)
(920) 803-1617
Entity
Organization
Contact information
Practice address
1125 N 13TH ST, SHEBOYGAN, WI 53081-3281
(920) 803-1617
(920) 803-1622
Mailing address
1125 N 13TH ST, SHEBOYGAN, WI 53081-3281
(920) 803-1617
(920) 803-1622
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41813000
—
WI
Enumeration date
04/02/2007
Last updated
07/27/2021
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