Casey  E  Cannon    RPT
Contract Details
Physiotherapy Associates
Facility name
Provider ID
P000000253
NPI
1790092658
Tax ID
382617193
Effective Date
7/21/2011
Last Updated
11/20/2024
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
6655 Quince Rd Suite 108
Memphis, TN 38119
United States
County
Shelby
Phone
9017559988 (Phone)
Billing Details
Address
6655 Quince Rd
Suite 108
Memphis, TN 38119
Billing Phone
2153518393
Specialty Type
Physical Therapy
Map
Address