Contract Details
Align Networks, Inc.
Facility name
Pro Impact Physical Therapy and Sports Performance
Provider ID
P000003410
NPI
1780813618
Tax ID
043821114
Effective Date
10/1/2007
Last Updated
4/12/2018
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
1160 Navarro Avenue
Montgomery, AL 36106
United States
County
Montgomery
Phone
8663890211 (Phone)
Billing Details
Address
P.O. Box 402355
Atlanta, GA 30384
Billing Phone
8663890211
Specialty Type
Physical Therapy
Map
Address