Provider Demographics
NPI:1073706370
Name:EXCEED PHYSICAL THERAPY, INC.
Entity Type:Organization
Organization Name:EXCEED PHYSICAL THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:
Authorized Official - Last Name:DUNN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:479-267-0713
Mailing Address - Street 1:2718 E FERGUSON AVE
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72703-4310
Mailing Address - Country:US
Mailing Address - Phone:479-267-0713
Mailing Address - Fax:
Practice Address - Street 1:95 S SOUTHWINDS RD
Practice Address - Street 2:SUITE 1
Practice Address - City:FARMINGTON
Practice Address - State:AR
Practice Address - Zip Code:72730
Practice Address - Country:US
Practice Address - Phone:479-267-0713
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-21
Last Update Date:2007-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPT 2659225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5X806Medicare PIN