Steve  A  Howe    RPT
Contract Details
Physiotherapy Associates--Trussville-Roebuck
Facility name
Provider ID
P000000792
NPI
1598818114
Tax ID
382617193
Effective Date
3/1/1999
Last Updated
6/5/2014
Direct Contract
Yes
Term Date
1/15/2014
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
616 Gadsden Highway Suite A
Birmingham, AL 35235
United States
County
Jefferson
Phone
2058330881 (Phone)
Billing Details
Address
P.O. Box 1245
Indiana, PA 15701
Billing Phone
7244653496
Specialty Type
Physical Therapy
Map
Address