Provider Demographics
NPI:1932537602
Name:EXCEL PHYSICAL THERAPY INC.
Entity Type:Organization
Organization Name:EXCEL PHYSICAL THERAPY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:SUMMERS
Authorized Official - Suffix:
Authorized Official - Credentials:PT, MPT, OCS, C-IDN
Authorized Official - Phone:330-868-4362
Mailing Address - Street 1:7735 STATE ROUTE 45
Mailing Address - Street 2:P.O. BOX 366
Mailing Address - City:LISBON
Mailing Address - State:OH
Mailing Address - Zip Code:44432-8342
Mailing Address - Country:US
Mailing Address - Phone:330-424-9033
Mailing Address - Fax:330-424-9053
Practice Address - Street 1:40 PARK DR
Practice Address - Street 2:
Practice Address - City:EAST PALESTINE
Practice Address - State:OH
Practice Address - Zip Code:44413-1850
Practice Address - Country:US
Practice Address - Phone:330-424-9033
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-16
Last Update Date:2013-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT006697261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2133588Medicaid
OH366686Medicare PIN