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General NPI Number Information
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NPI Number | 1184714719
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Entity Type | Organization
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Legal Business Name | EXCEL REHABILITATION, LLC.
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Dates
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Enumeration Date | 10/13/2006
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Last Update Date | 12/28/2012
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Provider Practice Location Address
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Address Line | 2125 E SOUTH BLVD
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City | MONTGOMERY
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State | AL
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Zip | 36116-2409
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Country | US
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Telephone | 334-532-0220
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Fax | 334-532-0221
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Provider Business Mailing Address
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Address Line | 399 MOUNTAIN RIDGE RD
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City | MILLBROOK
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State | AL
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Zip | 36054-2128
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Country | US
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Telephone | 334-285-7101
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MRS. RUSTY G BECKER
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Credential | OTR/L
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Telephone | 334-532-0220
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 2334
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License Number State | AL
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