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General NPI Number Information
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NPI Number | 1548621725
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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 | 03/15/2016
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Last Update Date | 02/23/2018
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Provider Practice Location Address
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Address Line | 1863 MAIN ST STE 101
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City | FERNDALE
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State | WA
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Zip | 98248-9059
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Country | US
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Telephone | 360-656-6534
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Fax | 360-778-1637
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Provider Business Mailing Address
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Address Line | 4029 NORTHWEST AVE STE 302
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City | BELLINGHAM
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State | WA
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Zip | 98226-9077
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Country | US
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Telephone | 360-734-2277
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Fax | 360-734-3006
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Authorized Official
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Title or Position | PRESIDENT
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Name | LISA OBERGOTTSBERGER
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Credential | PT
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Telephone | 360-734-2277
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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 | 00006753
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License Number State | WA
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