Deborah  E  Nelson    RPT
Contract Details
Southern Physical Rehab Network
Facility name
Provider ID
P000001250
NPI
1861474538
Tax ID
631019785
Effective Date
10/2/2000
Last Updated
6/9/2014
Direct Contract
Yes
Term Date
10/8/2013
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
IWR Therapy Systems 627 Highway 43 South, Suite B
Saraland, AL 36571
United States
County
Mobile
Phone
3346753390 (Phone)
Billing Details
Address
109 9th Street Southwest
Suite C
Cullman, AL 35055
Billing Phone
2567369926
Specialty Type
Physical Therapy
Map
Address