Contract Details
Southern Physical Rehab Network
Facility name
Physical Therapy of Andalusia
Provider ID
P000002333
NPI
1801065537
Tax ID
631055332
Effective Date
3/9/1998
Last Updated
4/12/2018
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
1105 West Bypass
Andalusia, AL 36420
United States
County
Covington
Phone
3342225785 (Phone)
Billing Details
Address
109 9th Street Southwest
Suite C
Cullman, AL 35055
Billing Phone
2567369926
Specialty Type
Physical Therapy
Map
Address