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General NPI Number Information
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NPI Number | 1982044947
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Entity Type | Organization
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Legal Business Name | EXCEL THERAPY SERVICES, INC.
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Dates
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Enumeration Date | 07/04/2013
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Last Update Date | 07/04/2013
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Provider Practice Location Address
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Address Line | 1006 GREEN RD
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City | CHATSWORTH
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State | GA
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Zip | 30705-2012
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Country | US
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Telephone | 706-271-6282
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Fax | 706-695-8425
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Provider Business Mailing Address
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Address Line | PO BOX 871
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City | CHATSWORTH
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State | GA
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Zip | 30705-0871
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Country | US
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Telephone | 706-271-6282
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Fax |
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Authorized Official
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Title or Position | CEO/PRESIDENT
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Name | MRS. TONYA RENA LEONARD
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Credential | P.T., CEAS
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Telephone | 706-271-6282
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251300000X
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Taxonomy Name | Local Education Agency (LEA)
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License Number | PT004205
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License Number State | GA
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