Robert    Kohn  Jr  RPT
Contract Details
Rehab Associates--Montgomery-Jackson Hospital
Facility name
Provider ID
P000000931
NPI
1003858689
Tax ID
721379381
Effective Date
8/28/1995
Last Updated
12/20/2016
Direct Contract
Yes
Term Date
12/14/2016
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
1801 Pine Street Suite 102
Montgomery, AL 36106
United States
County
Montgomery
Phone
3342626161 (Phone)
Billing Details
Address
P.O. Box 1245
Indiana, PA 15701
Billing Phone
7244653496
Specialty Type
Physical Therapy
Map
Address