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Stephen Mark
Guthrie
RPT
Contract Details
Drayer Physical Therapy Institute--Gardendale
Facility name
Provider ID
P000000671
NPI
1750477816
Tax ID
753050291
Effective Date
12/1/2010
Last Updated
8/26/2014
Direct Contract
Yes
Term Date
5/31/2014
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
651 Main Street Suite 119
Gardendale, AL 35071
United States
County
Jefferson
Phone
2056083113
(
Phone
)
Billing Details
Address
651 Main Street
Suite 119
Gardendale, AL 35071
Billing Phone
2056083113
Specialty Type
Physical Therapy
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