Contract Details
Southern Physical Rehab Network
Facility name
Back In Motion Physical Therapy
Provider ID
P000002005
NPI
1790953461
Tax ID
631254633
Effective Date
2/15/2005
Last Updated
4/12/2018
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
6460 Highway 11
Springville, AL 35146
United States
County
Saint Clair
Phone
2054679298 (Phone)
Billing Details
Address
109 9th Street Southwest
Suite C
Cullman, AL 35055
Billing Phone
2567369926
Specialty Type
Physical Therapy
Map
Address