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Contract Details
A Physiotherapy Associates Company
Facility name
Champion Sports Medicine & Rehabilitation Center
Provider ID
P000002042
NPI
1518976034
Tax ID
721379381
Effective Date
2/1/2006
Last Updated
4/12/2018
Direct Contract
Yes
Term Date
3/31/2017
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
608 Skyland Boulevard East
Tuscaloosa, AL 35405
United States
County
Tuscaloosa
Phone
2057522266
(
Phone
)
Billing Details
Address
P.O. Box 1245
Indiana, PA 15701
Billing Phone
7244653496
Specialty Type
Physical Therapy
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Address