# EXCEED PHYSICAL THERAPY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1023508348
- **Authorized official:** CHAD BLALACK (MANAGER)
- **Authorized official phone:** (228) 860-9676

## Contact information

- **Practice address:** 12261 HIGHWAY 49 STE 1, GULFPORT, MS 39503-2976
- **Practice address phone:** (228) 861-4218
- **Mailing address:** 3 BAYOU PL, GULFPORT, MS 39503-6202
- **Mailing address phone:** (228) 861-4218

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | NULL | Yes |
| 225100000X | Physical Therapist | — | — | Yes |

## Other

- **Enumeration date:** 05/11/2018
- **Last updated:** 05/11/2018