Provider Demographics
NPI:1922091032
Name:EXCEL REHABILITATION, PLLC
Entity Type:Organization
Organization Name:EXCEL REHABILITATION, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DUNCAN
Authorized Official - Middle Name:W
Authorized Official - Last Name:GERHARD
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DSC, MS
Authorized Official - Phone:703-383-1616
Mailing Address - Street 1:9860 FAIRFAX BLVD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-1737
Mailing Address - Country:US
Mailing Address - Phone:703-383-1616
Mailing Address - Fax:703-383-1166
Practice Address - Street 1:9860 FAIRFAX BLVD
Practice Address - Street 2:SUITE 1
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-1737
Practice Address - Country:US
Practice Address - Phone:703-383-1616
Practice Address - Fax:703-383-1166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-24
Last Update Date:2015-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAG00810Medicare UPIN