Provider Demographics
NPI:1326101999
Name:EXCEL THERAPY SERVICES LLC
Entity Type:Organization
Organization Name:EXCEL THERAPY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EDWIN
Authorized Official - Middle Name:TYLER
Authorized Official - Last Name:HALE
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:334-285-0239
Mailing Address - Street 1:772 MONUMENT DR
Mailing Address - Street 2:
Mailing Address - City:MILLBROOK
Mailing Address - State:AL
Mailing Address - Zip Code:36054-1849
Mailing Address - Country:US
Mailing Address - Phone:334-285-0239
Mailing Address - Fax:334-285-9689
Practice Address - Street 1:772 MONUMENT DR
Practice Address - Street 2:
Practice Address - City:MILLBROOK
Practice Address - State:AL
Practice Address - Zip Code:36054-1849
Practice Address - Country:US
Practice Address - Phone:334-285-0239
Practice Address - Fax:334-285-9689
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-18
Last Update Date:2007-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL515-30241OtherBCBS
ALS73118Medicare UPIN
ALK596Medicare PIN