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
Map
Address