Renee    Hall    OTR
Contract Details
USA Health System
Facility name
Provider ID
P000000690
NPI
1477592749
Tax ID
630725648
Effective Date
9/25/2005
Last Updated
6/10/2016
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
3421 Medical Park Drive
Mobile, AL 36693
United States
County
Mobile
Phone
2516658200 (Phone)
Billing Details
Address
P.O. Box 40480
Mobile, AL 36604
Specialty Type
Occupational Therapy
Map
Address