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NPI Code Detail

MEDICARE: EXCEL PERFORMANCE PHYSICAL THERAPY, P.C.

MEDICARE: EXCEL PERFORMANCE PHYSICAL THERAPY, P.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QP2000XPhysical Therapy Clinic/Center36994CA

General Provider Information

NPI Number : 1396138715
Entity Type Code : Organization
Provider Name (Legal Business Name) : EXCEL PERFORMANCE PHYSICAL THERAPY, P.C.
Provider Business Mailing Address
First Line : 121 WAUGH AVE
Second Line :
City : SANTA CRUZ
State : CA
Zip : 95065-1133
Country : US
Telephone Number : 831-566-2004
Fax Number : 831-325-0307
Provider Business Practice Location Address
First Line : 2650 RESEARCH PARK DR
Second Line :
City : SOQUEL
State : CA
Zip : 95073-2087
Country : US
Telephone Number : 831-566-2004
Fax Number : 831-325-0307
Authorized Official
Title or Position : OWNER
Name : JILL MCCORMICK
Credential : P.T.
Telephone Number : 831-566-2004
Provider Enumeration Date : 03/10/2015
Last Update Date : 03/10/2015

Similar Medicare Providers

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Practice Location Address:
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Practice Location Address:
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Directions to “EXCEL PERFORMANCE PHYSICAL THERAPY, P.C. ” Practice Location

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