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Contract Details
A Physiotherapy Associates Company
Facility name
Champion Sports Medicine & Rehabilitation Center - Morgan Village
Provider ID
P000002362
NPI
1871502591
Tax ID
721379381
Effective Date
6/1/1999
Last Updated
2/8/2019
Direct Contract
Yes
Term Date
1/31/2019
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
8000 Liberty Parkway Suite 108
Birmingham, AL 35242
United States
County
Shelby
Phone
2054810670
(
Phone
)
Billing Details
Address
P.O. Box 1245
Indiana, PA 15701
Billing Phone
7244653496
Specialty Type
Physical Therapy
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Address