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General NPI Number Information
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NPI Number | 1952272379
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Entity Type | Organization
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Legal Business Name | EXCEL REHABILITATION AND SPORTS
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Dates
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Enumeration Date | 09/17/2025
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Last Update Date | 09/26/2025
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Provider Practice Location Address
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Address Line | 77 POINTE CIR
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City | GREENVILLE
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State | SC
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Zip | 29615-3505
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Country | US
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Telephone | 864-233-4477
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Fax | 864-233-7844
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Provider Business Mailing Address
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Address Line | 625 KENMOOR AVE SE STE 100
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City | GRAND RAPIDS
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State | MI
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Zip | 49546-2395
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Country | US
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Telephone | 616-356-5000
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Fax | 616-356-5001
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Authorized Official
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Title or Position | CEO
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Name | RICHARD LEAVER
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Credential |
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Telephone | 616-356-5000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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