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
Map
Address