Christopher    Foster    RPT
Contract Details
Select Physical Therapy
Facility name
Provider ID
P000000559
Tax ID
631133454
Effective Date
12/1/1998
Last Updated
5/6/2014
Direct Contract
Yes
Term Date
5/6/2014
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
635 McQueen Smith Road North Suite B
Prattville, AL 36066
United States
County
Autauga
Phone
3343658063 (Phone)
Billing Details
Address
P.O. Box 534509
Atlanta, GA 30353
Billing Phone
3343658063
Specialty Type
Physical Therapy
Map
Address