Provider Demographics
NPI:1386933430
Name:PROGRESSIVE THERAPY SERVICES LLC
Entity type:Organization
Organization Name:PROGRESSIVE THERAPY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:R
Authorized Official - Last Name:TOLER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:603-491-1109
Mailing Address - Street 1:553 ROUTE 3A 3-1-N
Mailing Address - Street 2:
Mailing Address - City:BOW
Mailing Address - State:NH
Mailing Address - Zip Code:03304
Mailing Address - Country:US
Mailing Address - Phone:603-228-7711
Mailing Address - Fax:603-228-7701
Practice Address - Street 1:553 ROUTE 3A 3-1-N
Practice Address - Street 2:
Practice Address - City:BOW
Practice Address - State:NH
Practice Address - Zip Code:03304
Practice Address - Country:US
Practice Address - Phone:603-228-7711
Practice Address - Fax:603-228-7701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-29
Last Update Date:2011-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1354261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy