Provider Demographics
NPI:1639457781
Name:EXCEL PHYSICAL THERAPY
Entity Type:Organization
Organization Name:EXCEL PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:FRANZ
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMACHO
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:702-249-1881
Mailing Address - Street 1:5288 SPRING MOUNTAIN RD
Mailing Address - Street 2:SUITE #200
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146-8723
Mailing Address - Country:US
Mailing Address - Phone:702-249-1881
Mailing Address - Fax:702-248-3886
Practice Address - Street 1:5288 SPRING MOUNTAIN RD
Practice Address - Street 2:SUITE #200
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-8723
Practice Address - Country:US
Practice Address - Phone:702-249-1881
Practice Address - Fax:702-248-3886
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-22
Last Update Date:2011-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV1796225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty