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Contract Details
Southern Physical Rehab Network
Facility name
Provider ID
P000000096
NPI
1316017403
Tax ID
631150414
Effective Date
12/1/1997
Last Updated
6/9/2014
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
Huntsville Pool & Land Therapy 3303 Westmill Drive
Huntsville, AL 35805
United States
County
Madison
Phone
2565364777 (Phone)
Billing Details
Address
109 9th Street Southwest
Suite C
Cullman, AL 35055
Billing Phone
2567369926
Specialty Type
Physical Therapy
Map
Address