Steven Dennis    Estrada    RPT
Contract Details
Premier Physical Therapy
Facility name
Provider ID
P000000510
NPI
1548482524
Tax ID
204897118
Effective Date
3/1/2000
Last Updated
5/16/2016
Direct Contract
Yes
Term Date
5/30/2013
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
7088 University Court
Montgomery, AL 36117
United States
County
Montgomery
Phone
3343961400 (Phone)
Billing Details
Address
7088 University Court
Montgomery, AL 36117
Billing Phone
3343961400
Specialty Type
Physical Therapy
Map
Address