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Contract Details
Southern Physical Rehab Network
Facility name
Provider ID
P000000622
NPI
1447233135
Tax ID
010644646
Effective Date
4/19/2005
Last Updated
8/26/2014
Direct Contract
Yes
Term Date
8/26/2014
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
Physical Therapy of Phenix City 1321 9th Avenue
Phenix City, AL 36867
United States
County
Russell
Phone
3344482641 (Phone)
Billing Details
Address
1321 9th Avenue
Phenix City, AL 36867
Billing Phone
3344482641
Specialty Type
Physical Therapy
Map
Address