Contract Details
Facility name
Montgomery Spine Center
Provider ID
P000002271
NPI
1568521169
Tax ID
631237270
Effective Date
1/1/2000
Last Updated
9/3/2015
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
F
Fee Schedule Name
103.00
Fee Schedule Multiplier
Location Details
Address
257 Winton Blount Loop
Montgomery, AL 36117
United States
County
Montgomery
Phone
3343961886 (Phone)
Billing Details
Address
P.O. Box 231509
Montgomery, AL 36123
Billing Phone
3343961886
Specialty Type
Surgery, Orthopedic
Map
Address