Healthcare Provider Details

I. General information

NPI: 1649344946
Provider Name (Legal Business Name): EXCEL PHYSICAL THERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2006
Last Update Date: 08/30/2022
Certification Date: 08/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

912 E LINCOLNWAY
MINERVA OH
44657-1214
US

IV. Provider business mailing address

912 E LINCOLNWAY
MINERVA OH
44657-1214
US

V. Phone/Fax

Practice location:
  • Phone: 330-868-4362
  • Fax: 330-424-9033
Mailing address:
  • Phone: 330-868-4362
  • Fax: 330-424-9053

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT6697
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. GEORGE A SUMMERS
Title or Position: OWNER, PHYSICAL THERAPIST
Credential: PT, MPT, OCS
Phone: 330-868-4362