Laura Brook    Edmundson    RPT
Contract Details
EW Motion Therapy--Birmingham-Homewood
Facility name
Provider ID
P000000471
NPI
1467545475
Tax ID
631239495
Effective Date
11/1/2006
Last Updated
6/3/2016
Direct Contract
Yes
Term Date
5/9/2013
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
3125 Independence Drive Suite 300-B
Birmingham, AL 35209
United States
County
Jefferson
Phone
2058797501 (Phone)
Billing Details
Address
3125 Independence Drive
Suite 300-B
Birmingham, AL 35209
Billing Phone
2058797501
Specialty Type
Physical Therapy
Map
Address