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Dirk
A
Carson
RPT
Contract Details
Carson Physical Therapy
Facility name
Provider ID
P000000264
NPI
1093804262
Tax ID
264585533
Effective Date
3/30/2023
Last Updated
4/5/2023
Direct Contract
Yes
Status
Active
W9 Attachment
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
75.00
Location Details
Address
4466A Jeff Road
Toney, AL 35773
United States
County
Madison
Phone
256-213-1917
(
Phone
)
Billing Details
Address
4466A Jeff Road
Toney, AL 35773
Billing Phone
256-213-1917
Specialty Type
Physical Therapy
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Address