Lydia    Haynes    RPT
Contract Details
Integrity Sports Medicine & Rehabilitation
Facility name
Provider ID
P000000733
NPI
1861457103
Tax ID
203300796
Effective Date
9/15/2005
Last Updated
6/9/2016
Direct Contract
Yes
Term Date
5/29/2013
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
1811 Dahlke Drive
Cullman, AL 35058
United States
County
Cullman
Phone
2567391370 (Phone)
Billing Details
Address
1811 Dahlke Drive
Cullman, AL 35058
Specialty Type
Physical Therapy
Map
Address