Contract Details
A Physiotherapy Associates Company
Facility name
Champion Sports Medicine & Rehabilitation Center - Colonnade
Provider ID
P000002047
NPI
1871677120
Tax ID
721379381
Effective Date
7/1/2005
Last Updated
4/12/2018
Direct Contract
Yes
Term Date
2/17/2014
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
3427 Colonnade Parkway
Birmingham, AL 35243
United States
County
Jefferson
Phone
2059692354 (Phone)
Billing Details
Address
P.O. Box 1245
Indiana, PA 15701
Billing Phone
7244653496
Specialty Type
Physical Therapy
Map
Address