Contract Details
Facility name
Physiotherapy Associates
Provider ID
P000002339
NPI
1821194523
Tax ID
382617193
Effective Date
3/1/1999
Last Updated
4/12/2018
Direct Contract
Yes
Term Date
8/14/2013
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
1603 Decatur Highway Suite 103
Gardendale, AL 35071
United States
County
Jefferson
Phone
2056314002 (Phone)
Billing Details
Address
P.O. Box 1245
Indiana, PA 15701
Billing Phone
7244653496
Specialty Type
Physical Therapy
Map
Address