Member Login
Home
About Us
Become a Provider
Become a Member
Administrators
Contact Us
Member Login
Ronald
T
Moon
DO
Contract Details
The Industrial Athlete
Facility name
Provider ID
P000001184
NPI
1043203334
Tax ID
631205801
Effective Date
5/1/1999
Last Updated
5/13/2014
Direct Contract
Yes
Term Date
5/1/1999
Status
Contract Discounts
Discount Type
M
Exhibit ID
AM_084
AM_084
Location Details
Address
820 University Boulevard
Birmingham, AL 35233
United States
County
Jefferson
Phone
2053275030
(
Phone
)
Billing Details
Address
Specialty Type
Physical Medicine & Rehabilitation
Map
Address