Todd    Howatt    RPT
Contract Details
Southern Physical Rehab Network
Facility name
Provider ID
P000000791
NPI
1518932417
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 2691 Pelham Parkway
Pelham, AL 35124
United States
County
Shelby
Phone
2056558866 (Phone)
Billing Details
Address
109 9th Street Southwest
Suite C
Cullman, AL 35055
Billing Phone
2567369926
Specialty Type
Physical Therapy
Map
Address