Contract Details
A Physiotherapy Associates Company
Facility name
Champion Sports Medicine & Rehabilitation Center - Hueytown
Provider ID
P000002039
NPI
1619202942
Tax ID
721379381
Effective Date
7/1/2005
Last Updated
4/12/2018
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
3014 Allison Bonnett Memorial Drive Suites 144 & 146
Hueytown, AL 35023
United States
County
Jefferson
Phone
2057449444 (Phone)
Billing Details
Address
P.O. Box 1245
Indiana, PA 15701
Billing Phone
7244653496
Specialty Type
Physical Therapy
Map
Address