Ginger  C  Roberts    RPT
Contract Details
Champion Sports Medicine--Anniston/Oxford
Facility name
Provider ID
P000001475
NPI
1457316903
Tax ID
721379381
Effective Date
7/1/2011
Last Updated
6/5/2014
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
2111 Highway 78 East Suite 2
Anniston, AL 36207
United States
County
Calhoun
Phone
2568321988 (Phone)
Billing Details
Address
P.O. Box 1245
Indiana, PA 15701
Billing Phone
7244653496
Specialty Type
Physical Therapy
Map
Address