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Organization
ORTHOPEDIC AND SPORTS PHYSICAL THERAPY SERVICES, INC.
Active
Organization
ORTHOPEDIC AND SPORTS PHYSICAL THERAPY SERVICES, INC.
Active
Other names
Excel Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL RUCKER (CEO)
(914) 294-4050
Entity
Organization
Contact information
Practice address
420 BAINBRIDGE ST, PHILADELPHIA, PA 19147-1568
(215) 629-1270
(215) 629-1293
Mailing address
1311 MAMARONECK AVE STE 140, WHITE PLAINS, NY 10605-5224
(914) 294-4050
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0099493
AETNA HMO GROUP #
PA
01
—
0444631000
KEYSTONE GROUP #
PA
01
—
118100606
US DEPT. OF LABOR GRP #
—
01
—
2020801
HGHMARK BLUE SHIELD
NJ
01
—
4566762
AETNA PPO GROUP #
PA
01
—
966448
BCBS PPO GROUP #
PA
01
—
A2590262
OXFORD GROUP #
PA
Enumeration date
07/07/2005
Last updated
08/12/2022
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