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Contract Details
Hanger Prosthetics & Orthotics, Inc.
Facility name
Hanger Clinic
Provider ID
P000002175
NPI
1558433292
Tax ID
521486235
Effective Date
6/15/2003
Last Updated
8/21/2014
Direct Contract
Yes
Status
Active
W9 Attachment
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
321 Westgate Parkway Suite 2
Dothan, AL 36303
United States
County
Houston
Phone
3347122850
(
Phone
)
Billing Details
Address
321 Westgate Parkway
Suite 2
Dothan, AL 36303
Billing Phone
3347122850
Specialty Type
Orthotics/Prosthetics, Services
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Address