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Contract Details
Southern Physical Rehab Network
Facility name
IWR Therapy Systems
Provider ID
P000002212
NPI
1437214574
Tax ID
631019785
Effective Date
9/21/1998
Last Updated
5/21/2017
Direct Contract
Yes
Term Date
10/8/2013
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
2048 South Broad Street Brookley Complex, Suite A
Mobile, AL 36615
United States
County
Mobile
Phone
2514331414
(
Phone
)
Billing Details
Address
109 9th Street Southwest
Suite C
Cullman, AL 35055
Billing Phone
2567369926
Specialty Type
Physical Medicine & Rehabilitation
Map
Address