Edwin Tyler    Hale    RPT
Contract Details
Excel Therapy Services, LLC
Facility name
Provider ID
P000000683
NPI
1841227543
Tax ID
270127590
Effective Date
10/1/2005
Last Updated
6/9/2016
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
75.00
Location Details
Address
40 Wisteria Place
Millbrook, AL 36054
United States
County
Elmore
Phone
3342850239 (Phone)
Billing Details
Address
772 Monument Drive
Millbrook, AL 36054
Billing Phone
3342850239
Specialty Type
Physical Therapy
Map
Address