Contract Details
Southern Physical Rehab Network
Facility name
PT Solutions of South Montgomery
Provider ID
P000002318
NPI
1972533974
Tax ID
470907536
Effective Date
1/1/2004
Last Updated
4/12/2018
Direct Contract
Yes
Term Date
1/19/2016
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
2065 East South Boulevard
Montgomery, AL 36116
United States
County
Montgomery
Phone
3342888358 (Phone)
Billing Details
Address
109 9th Street Southwest
Suite C
Cullman, AL 35055
Billing Phone
2567369926
Specialty Type
Physical Therapy
Map
Address