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Kimberly
Bonner
RPT
Contract Details
Tuscaloosa Physical Therapy Center, Inc
Facility name
Provider ID
P000000169
Tax ID
631114198
Effective Date
12/1/1997
Last Updated
9/29/2016
Direct Contract
Yes
Term Date
9/27/2016
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
1725 University Blvd East
Tuscaloosa, AL 35405
United States
County
Tuscaloosa
Phone
2055562110
(
Phone
)
Billing Details
Address
Specialty Type
Physical Therapy
Map
Address