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Brian
P
Sweet
DO
Contract Details
Industrial Health Services, LLC
Facility name
Provider ID
P000001697
NPI
1780608042
Tax ID
631280888
Effective Date
10/19/2001
Last Updated
5/29/2013
Direct Contract
Yes
Term Date
5/29/2013
Status
Contract Discounts
Discount Type
F
Fee Schedule Name
103.00
Fee Schedule Multiplier
Location Details
Address
499 Saint Lukes Drive
Montgomery, AL 36117
United States
County
Montgomery
Phone
3342605111
(
Phone
)
Billing Details
Address
Specialty Type
Family Practice
Map
Address