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General NPI Number Information
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NPI Number | 1417373572
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Entity Type | Organization
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Legal Business Name | EXCEL PHYSICAL THERAPY INC.
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Dates
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Enumeration Date | 03/13/2014
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Last Update Date | 08/30/2022
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Provider Practice Location Address
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Address Line | 108 NORTH MAIN STREET
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City | WAYNESBURG
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State | OH
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Zip | 44688
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Country | US
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Telephone | 330-868-4362
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Fax | 330-868-5146
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Provider Business Mailing Address
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Address Line | PO BOX 366
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City | LISBON
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State | OH
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Zip | 44432-0366
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Country | US
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Telephone | 330-424-9033
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Fax | 330-424-9053
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | MR. GEORGE ALAN SUMMERS
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Credential | PT, MPT, OCS, C-IDN
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Telephone | 330-868-4362
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | PT006697
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License Number State | OH
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