Mindi Meadows    Posey    RPT
Contract Details
TheraSport Physical & Aquatic Therapy
Facility name
Provider ID
P000001132
NPI
1487709226
Tax ID
481308430
Effective Date
5/15/2003
Last Updated
9/11/2014
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
70.00
Location Details
Address
598 Main Street East
Rainsville, AL 35986
United States
County
De Kalb
Phone
2566381150 (Phone)
Billing Details
Address
124 McCurdy Avenue South
Suite B
Rainsville, AL 35986
Billing Phone
2566381150
Specialty Type
Physical Therapy
Map
Address