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Organization
EXCEED PHYSICAL THERAPY, LLC
Active
Organization
EXCEED PHYSICAL THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHAD BLALACK (MANAGER)
(228) 860-9676
Entity
Organization
Contact information
Practice address
12261 HIGHWAY 49 STE 1, GULFPORT, MS 39503-2976
(228) 861-4218
Mailing address
3 BAYOU PL, GULFPORT, MS 39503-6202
(228) 861-4218
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
NULL
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
05/11/2018
Last updated
05/11/2018
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