Provider Demographics
NPI:1417098526
Name:EXCEL PHYSICAL THERAPY,INC.
Entity Type:Organization
Organization Name:EXCEL PHYSICAL THERAPY,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:AURDEY
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:401-944-7574
Mailing Address - Street 1:51 SOCKANOSSET CROSS RD
Mailing Address - Street 2:
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02920-5536
Mailing Address - Country:US
Mailing Address - Phone:401-944-7574
Mailing Address - Fax:401-944-7602
Practice Address - Street 1:51SOCKANOSSET CROSSROAD
Practice Address - Street 2:
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02920-5558
Practice Address - Country:US
Practice Address - Phone:401-944-7574
Practice Address - Fax:401-944-7602
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-09
Last Update Date:2010-09-20
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
RI659094768Medicare PIN