Contract Details
Southern Physical Rehab Network
Facility name
Orthopaedic Physical Therapy
Provider ID
P000002307
NPI
1093929168
Tax ID
721367666
Effective Date
12/1/1997
Last Updated
4/12/2018
Direct Contract
Yes
Term Date
8/30/2013
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
101 West College Street Suite C
Columbiana, AL 35051
United States
County
Shelby
Phone
2056699919 (Phone)
Billing Details
Address
109 9th Street Southwest
Suite C
Cullman, AL 35055
Billing Phone
2567369926
Specialty Type
Physical Therapy
Map
Address