John  W  Ware    RPT
Contract Details
Saraland Physical Therapy Services
Facility name
Provider ID
P000001823
NPI
1477536407
Tax ID
631228876
Effective Date
1/1/2003
Last Updated
4/22/2015
Direct Contract
Yes
Term Date
1/27/2015
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
205 Highway 43 North
Saraland, AL 36571
United States
County
Mobile
Phone
2516790015 (Phone)
Billing Details
Address
205 Highway 43 North
Saraland, AL 36571
Billing Phone
2516790015
Specialty Type
Physical Therapy
Map
Address