Kelley  M  Zajac    RPT
Contract Details
Southern Physical Rehab Network
Facility name
Provider ID
P000001922
NPI
1922042670
Tax ID
200334591
Effective Date
1/1/2004
Last Updated
6/9/2014
Direct Contract
Yes
Term Date
8/30/2013
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
Accelerated Physical Therapy 16618 Highway 280, Suite 102
Chelsea, AL 35043
United States
County
Shelby
Phone
2056785035 (Phone)
Billing Details
Address
109 9th Street Southwest
Suite C
Cullman, AL 35055
Billing Phone
2567369926
Specialty Type
Physical Therapy
Map
Address