Healthcare Provider Details

I. General information

NPI: 1730131467
Provider Name (Legal Business Name): EXCEL PHYSICAL THERAPY LIMITED PARTNERSHIP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2006
Last Update Date: 06/19/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 E BOGARD RD BLDG B #203
WASILLA AK
99654-6563
US

IV. Provider business mailing address

1700 E BOGARD RD BLDG B #203
WASILLA AK
99654-6563
US

V. Phone/Fax

Practice location:
  • Phone: 713-297-7000
  • Fax: 713-297-7090
Mailing address:
  • Phone: 713-297-7000
  • Fax: 713-297-7090

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: LAWRANCE W MCAFEE
Title or Position: CFO
Credential:
Phone: 713-297-7000