Contract Details
A Physiotherapy Associates Company
Facility name
Champion Sports Medicine & Rehabilitation Center - Toney
Provider ID
P000002049
NPI
1639353584
Tax ID
721379381
Effective Date
3/1/1999
Last Updated
4/4/2023
Direct Contract
Yes
Term Date
3/29/2023
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
4466 Jeff Road
Harvest, AL 35773
United States
County
Madison
Phone
2568526900 (Phone)
Billing Details
Address
4466 Jeff Road
Indiana, PA 35773
Billing Phone
7244653496
Specialty Type
Physical Therapy
Map
Address