Edwin  P  Grice  III  RPT
Contract Details
Rehab Associates--Prattville
Facility name
Provider ID
P000000653
NPI
1275568743
Tax ID
721379381
Effective Date
8/28/1995
Last Updated
6/4/2014
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
1824 Glynwood Drive
Prattville, AL 36066
United States
County
Autauga
Phone
3343614711 (Phone)
Billing Details
Address
P.O. Box 1245
Indiana, PA 15701
Billing Phone
7244653496
Specialty Type
Physical Therapy
Map
Address