Basic Information
| Provider Information | |||||||||
| NPI: | 1346422888 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | EXCEL PHYSICAL THERAPY LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 28977 WALKER RD S | ||||||||
| Address2: | SUITE G | ||||||||
| City: | WALKER | ||||||||
| State: | LA | ||||||||
| PostalCode: | 707856049 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2252718056 | ||||||||
| FaxNumber: | 2252718057 | ||||||||
| Practice Location | |||||||||
| Address1: | 28977 WALKER RD S | ||||||||
| Address2: | SUITE G | ||||||||
| City: | WALKER | ||||||||
| State: | LA | ||||||||
| PostalCode: | 707856049 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2252718056 | ||||||||
| FaxNumber: | 2262718057 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/27/2007 | ||||||||
| LastUpdateDate: | 09/11/2014 | ||||||||
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| AuthorizedOfficialLastName: | LOUVIERE | ||||||||
| AuthorizedOfficialFirstName: | MARVIN | ||||||||
| AuthorizedOfficialMiddleName: | J | ||||||||
| AuthorizedOfficialTitleorPosition: | PARTNER | ||||||||
| AuthorizedOfficialTelephone: | 2252718056 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QP2000X | 07076 | LA | Y | Ambulatory Health Care Facilities | Clinic/Center | Physical Therapy |
No ID Information.