Contract Details
A Physiotherapy Associates Company
Facility name
Champion Sports Medicine & Rehabilitation
Provider ID
P000002044
NPI
1659380160
Tax ID
721379381
Effective Date
1/1/2005
Last Updated
4/12/2018
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
2470 Rocky Ridge Road Suite 102
Birmingham, AL 35243
United States
County
Jefferson
Phone
2058244525 (Phone)
Billing Details
Address
P.O. Box 1245
Indiana, PA 15701
Billing Phone
7244653496
Specialty Type
Physical Therapy
Map
Address