Emmett  L  Parker    RPT
Contract Details
Southern Physical Rehab Network
Facility name
Provider ID
P000001318
NPI
1992761597
Tax ID
200334591
Effective Date
1/1/2004
Last Updated
11/7/2017
Direct Contract
Yes
Term Date
11/1/2017
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
Accelerated Physical Therapy 1808 Gadsden Highway, Suite 136
Birmingham, AL 35235
United States
County
Jefferson
Phone
2056558866 (Phone)
Billing Details
Address
109 9th Street Southwest
Suite C
Cullman, AL 35055
Billing Phone
2567369926
Specialty Type
Physical Therapy
Map
Address