Name: Boltz Pain and Wellness Center, LLC
Address: 1 Timber Way Suite 203, Spanish Fort, 36527, United States
Telephone: 2514457225

Contract Details

Facility name

Boltz Pain and Wellness Center, LLC

Provider ID

P000002020

NPI

1235381013

Tax ID

263478129

Effective Date

3/1/2010

Last Updated

4/18/2013

Direct Contract

Yes

Status

Active

Contract Discounts

Discount Type

State Fee Schedule Multiplier

80.00

Location Details

Address

1 Timber Way Suite 203

Spanish Fort, AL 36527

United States

County

Baldwin

Phone

2514457225 (Phone)

Billing Details

Address

1 Timber Way

Suite 203

Spanish Fort, AL 36527

Billing Phone

Specialty Type

Pain Management Facility

Map