Contract Details
Align Networks, Inc.
Facility name
Azalea City Hand & Rehab
Provider ID
P000002004
NPI
1760588503
Tax ID
043821114
Effective Date
10/1/2007
Last Updated
4/12/2018
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
1455 College Avenue
Jackson, AL 36545
United States
County
Clarke
Phone
8663890211 (Phone)
Billing Details
Address
P.O. Box 402355
Atlanta, GA 30384
Billing Phone
Specialty Type
Physical Therapy
Map
Address