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Virginia Leigh
Childress
RPT
Contract Details
PT Solutions
Facility name
Provider ID
P000000295
NPI
1881841419
Tax ID
270202352
Effective Date
8/18/1992
Last Updated
6/9/2016
Direct Contract
Yes
Term Date
9/19/2013
Status
W9 Attachment
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
305 North Water Street Suite A
Mobile, AL 36602
United States
County
Mobile
Phone
2514315800
(
Phone
)
Billing Details
Address
P.O. Box 242757
Montgomery, AL 36124
Specialty Type
Physical Therapy
Map
Address