Provider Demographics
NPI:1841412475
Name:EXCEL REHABILITATION SERVICES INC.
Entity Type:Organization
Organization Name:EXCEL REHABILITATION SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LISCENSED PHYSICAL THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:TONYA
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:CHADWELL
Authorized Official - Suffix:
Authorized Official - Credentials:LPT
Authorized Official - Phone:606-862-8333
Mailing Address - Street 1:3104 PINE TOP RD
Mailing Address - Street 2:
Mailing Address - City:LONDON
Mailing Address - State:KY
Mailing Address - Zip Code:40741
Mailing Address - Country:US
Mailing Address - Phone:606-862-8333
Mailing Address - Fax:606-862-8618
Practice Address - Street 1:19126 SOUTH HWY 421
Practice Address - Street 2:
Practice Address - City:HYDEN
Practice Address - State:KY
Practice Address - Zip Code:41749
Practice Address - Country:US
Practice Address - Phone:606-672-4546
Practice Address - Fax:606-672-4547
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2015-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY004016225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY5027801OtherMEDICARE ID FOR TONYA CHADWELL LPT
KY8871Medicare PIN