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Organization
XCELERATE PHYSICAL THERAPY INC.
Active
Organization
XCELERATE PHYSICAL THERAPY INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRANDON DEDERICH (PT)
(805) 552-1915
Entity
Organization
Contact information
Practice address
144 W LOS ANGELES AVE, STE 110, MOORPARK, CA 93021-1898
(805) 374-9900
(805) 374-9910
Mailing address
144 W LOS ANGELES AVE, STE 110, MOORPARK, CA 93021-1898
(805) 374-9900
(805) 374-9910
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
264440100
DEPT. OF LABOR
CA
01
—
ZZZ67264
BLUE SHIELD
CA
Enumeration date
02/14/2007
Last updated
08/01/2022
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