Organization
EXCELERATED REHAB & FITNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER T STEWART PT (OWNER)
(601) 466-9938
Entity
Organization
Contact information
Practice address
7 WILLOW BEND DR, HATTIESBURG, MS 39402-8552
(601) 599-0260
(601) 599-0261
Mailing address
7 WILLOW BEND DR, HATTIESBURG, MS 39402-8552
(601) 599-0260
(601) 599-0261
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
3116
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07526041
—
MS
Enumeration date
12/30/2008
Last updated
04/23/2010
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