DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: EXCEL PHYSICAL THERAPY & SPORTS MEDICINE CLINIC

MEDICARE: EXCEL PHYSICAL THERAPY & SPORTS MEDICINE CLINIC
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
1225100000XPhysical Therapist108639MO

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2DA1611OTHERMOMEDICARE RAILROAD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1122566OTHERBLUE CROSS BLUE SHEILD

General Provider Information

NPI Number : 1609930593
Entity Type Code : Organization
Provider Name (Legal Business Name) : EXCEL PHYSICAL THERAPY & SPORTS MEDICINE CLINIC
Provider Business Mailing Address
First Line : 1420 W ASHLEY RD
Second Line :
City : BOONVILLE
State : MO
Zip : 65233-2112
Country : US
Telephone Number : 660-882-6115
Fax Number : 660-882-6120
Provider Business Practice Location Address
First Line : 1420 W ASHLEY RD
Second Line :
City : BOONVILLE
State : MO
Zip : 65233-2112
Country : US
Telephone Number : 660-882-6115
Fax Number : 660-882-6120
Authorized Official
Title or Position : OWNER
Name : JILL S MCCORMICK
Credential : P.T., A.T.C.
Telephone Number : 773-892-7501
Provider Enumeration Date : 12/21/2006
Last Update Date : 10/16/2007

Similar Medicare Providers

1891790291 — MRS. JENNIFER JO HACKMAN P.T. ,A.T.C.
Practice Location Address:
1420 W ASHLEY RD
BOONVILLE, MO
65233-2112
Practice Phone: 660-882-6115
Practice Fax: 660-882-6120
1003811258 — MISS KELLEY NICOLE TATE P.T.
Practice Location Address:
1420 W ASHLEY RD
BOONVILLE, MO
65233-2112
Practice Phone: 660-882-6115
Practice Fax: 660-882-6120
1245340371 — MRS. ANDREA THERESA HOEHN MOT OTR/L
Practice Location Address:
1420 W ASHLEY RD
BOONVILLE, MO
65233-2112
Practice Phone: 660-882-6115
Practice Fax:
1477672814 — JOHN LEE TATE PTA
Practice Location Address:
1420 W ASHLEY RD
BOONVILLE, MO
65233-2112
Practice Phone: 660-882-6115
Practice Fax:
1124264775 — SAMMY H GOEDRICH OTR
Practice Location Address:
1420 W ASHLEY RD
BOONVILLE, MO
65233-2112
Practice Phone: 660-882-6115
Practice Fax:
1134451313 — LINDSEY SCHEETS ATC
Practice Location Address:
1420 W ASHLEY RD
BOONVILLE, MO
65233-2112
Practice Phone: 660-882-6115
Practice Fax:

Directions to “EXCEL PHYSICAL THERAPY & SPORTS MEDICINE CLINIC ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.