Ronald  T  Moon    DO
Contract Details
The Industrial Athlete
Facility name
Provider ID
P000001184
NPI
1043203334
Tax ID
631205801
Effective Date
5/1/1999
Last Updated
6/5/2019
Direct Contract
Yes
Term Date
6/4/2019
Status
Contract Discounts
Discount Type
M
Exhibit ID
AM_084
Location Details
Address
820 University Boulevard
Birmingham, AL 35233
United States
County
Jefferson
Phone
2053275030 (Phone)
Billing Details
Address
820 University Boulevard
Birmingham, AL 35233
Billing Phone
2053275030
Specialty Type
Physical Medicine & Rehabilitation
Map
Address