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Contract Details
Align Networks, Inc.
Facility name
Total Life Connection Physical Therapy Center
Provider ID
P000003448
NPI
1013199876
Tax ID
043821114
Effective Date
10/1/2007
Last Updated
4/12/2018
Direct Contract
No
Term Date
8/26/2013
Status
W9 Attachment
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
6709 Taylor Circle
Montgomery, AL 36117
United States
County
Montgomery
Phone
8663890211
(
Phone
)
Billing Details
Address
P.O. Box 402355
Atlanta, GA 30384
Billing Phone
8663890211
Specialty Type
Physical Therapy
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Address