OrganizationProgressive Physical Therapy, Pa(Progressive Physical Therapy Midlands Irmo)Physical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address1013 Lake Murray Blvd, Irmo, SC 29063-2824(803) 602-0220(803) 758-2602PECOS EnrollmentBased on the most recent information from CMS, provider Progressive Physical Therapy, Pa does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 11:47 AM.Profile DetailsProvider ID1184007031Provider TypeOrganizationFull NameProgressive Physical Therapy, PaOther NameProgressive Physical Therapy Midlands IrmoSubpartNoEnumeration Date7/9/2015Last Updated7/9/2015Contact InformationPractice LocationPractice Address1013 Lake Murray Blvd, Irmo, SC 29063-2824Phone(803) 602-0220Fax(803) 781-7424Mailing LocationMailing Address1818 Henderson St, Columbia, SC 29201-2619Phone(803) 758-2602Fax(803) 253-8896Authorized OfficialNameFitch, Barry E (President)Phone(803) 731-4055Provider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicenseUnlisted IssuerCode2251H1200XDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicenseUnlisted IssuerCode225X00000XDescriptionOccupational TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicenseUnlisted IssuerProvider IdentifiersIDDescriptionIssuerIDGP0231DescriptionMedicaidIssuerUnlistedSouth Carolina