| Progressive Health Clinic, Llc | |
|
29g Miracle Strip Pkwy Sw Fort Walton Beach FL 32548-6655 | |
| (334) 437-4308 | |
| Not Available |
| Full Name | Progressive Health Clinic, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 29g Miracle Strip Pkwy Sw, Fort Walton Beach, Florida |
| Authorized Official Name and Position | Andrew A Godwin (OWNER/PROVIDER) |
| Authorized Official Contact | 8503743926 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Progressive Health Clinic, Llc 29g Miracle Strip Pkwy Sw Fort Walton Beach FL 32548-6655 Ph: () - | Progressive Health Clinic, Llc 29g Miracle Strip Pkwy Sw Fort Walton Beach FL 32548-6655 Ph: (334) 437-4308 |
| NPI Number | 1811457716 |
|---|---|
| Provider Enumeration Date | 03/25/2019 |
| Last Update Date | 04/24/2019 |
| Medicare PECOS PAC ID | 2567703218 |
|---|---|
| Medicare Enrollment ID | O20190408001603 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811457716 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Andrew A Godwin |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1558808659 PECOS PAC ID: 8921384892 Enrollment ID: I20180518001674 |
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