Provider Demographics
NPI:1467909937
Name:XCEL MOVEMENT AND PERFORMANCE, LLC
Entity Type:Organization
Organization Name:XCEL MOVEMENT AND PERFORMANCE, LLC
Other - Org Name:XCEL MOVEMENT AND PERFORMANCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:919-473-6165
Mailing Address - Street 1:6320 ANGUS DRIVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27617
Mailing Address - Country:US
Mailing Address - Phone:919-473-6165
Mailing Address - Fax:
Practice Address - Street 1:6320 ANGUS DR
Practice Address - Street 2:SUITE A
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27617-4756
Practice Address - Country:US
Practice Address - Phone:919-473-6165
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-01
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC15362225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty