Contract Details
A Physiotherapy Associates Company
Facility name
Champion Sports Medicine
Provider ID
P000002038
NPI
1659680213
Tax ID
382617193
Effective Date
3/1/1999
Last Updated
4/12/2018
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
201 Doug Baker Boulevard
Birmingham, AL 35242
United States
County
Shelby
Phone
2054080700 (Phone)
Billing Details
Address
P.O. Box 1245
Indiana, PA 15701
Billing Phone
7244653496
Specialty Type
Physical Therapy
Map
Address