Contract Details
Southern Physical Rehab Network
Facility name
TherapySouth Vestavia
Provider ID
P000002470
NPI
1295830404
Tax ID
205071801
Effective Date
12/5/2006
Last Updated
4/12/2018
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
1944 Canyon Road Suite 100
Birmingham, AL 35216
United States
County
Jefferson
Phone
2058227607 (Phone)
Billing Details
Address
109 9th Street Southwest
Suite C
Cullman, AL 35055
Billing Phone
2567369926
Specialty Type
Physical Therapy
Map
Address