Organization
EXCEL PHYSICAL THERAPY AND SPORTS PERFORMANCE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK EDWARD NICHOLS PT (PHYSICAL THERAPIST/OWNER)
(304) 881-5042
Entity
Organization
Contact information
Practice address
3540 TEAYS VALLEY RD, HURRICANE, WV 25526-9054
(304) 881-5042
(304) 562-7821
Mailing address
3540 TEAYS VALLEY RD, HURRICANE, WV 25526-9054
(304) 881-5042
(304) 562-7821
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
02111
WV
Other
Enumeration date
12/10/2013
Last updated
01/26/2016
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