1649344946 NPI number — EXCEL PHYSICAL THERAPY INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649344946 NPI number — EXCEL PHYSICAL THERAPY INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
EXCEL PHYSICAL THERAPY INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1649344946
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/30/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
912 E LINCOLNWAY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MINERVA
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44657-1214
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
330-868-4362
Provider Business Mailing Address Fax Number:
330-424-9053

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
912 E LINCOLNWAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MINERVA
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44657-1214
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
330-868-4362
Provider Business Practice Location Address Fax Number:
330-424-9033
Provider Enumeration Date:
11/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SUMMERS
Authorized Official First Name:
GEORGE
Authorized Official Middle Name:
A
Authorized Official Title or Position:
OWNER, PHYSICAL THERAPIST
Authorized Official Telephone Number:
330-868-4362

Provider Taxonomy Codes

  • Taxonomy code: 261QP2000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225100000X , with the licence number: PT6697 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2133588 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com