Organization Name: | EXCEL PHYSICAL THERAPY & SPORTS MEDICINE CLINIC |
NPI Number: | 1609930593 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JILL S MCCORMICK (OWNER) |
Mailing Address: | 1420 W Ashley Rd Boonville |
State: | MO US |
Postal Code: | 652332112 |
Phone Number: | 6608826115 |
Fax Number: | 6608826120 |
NPI Enumeration Date: | 12/21/2006 |
NPI Last Update Date: | 10/16/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 108639 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |