Provider Demographics
NPI:1477845220
Name:EXCELL SPORTS CHIROPRACTIC & REHAB, LLC
Entity Type:Organization
Organization Name:EXCELL SPORTS CHIROPRACTIC & REHAB, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MARCUS
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCRAY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:317-429-9031
Mailing Address - Street 1:8660 GUION RD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46268-3011
Mailing Address - Country:US
Mailing Address - Phone:317-429-9031
Mailing Address - Fax:317-388-8002
Practice Address - Street 1:8660 GUION RD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46268-3011
Practice Address - Country:US
Practice Address - Phone:317-429-9031
Practice Address - Fax:317-388-8002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-12
Last Update Date:2011-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08002244A261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center