Sharon  B  Young    RPT
Contract Details
Mobile Spine & Rehabilitation Center
Facility name
Provider ID
P000001920
NPI
1396705281
Tax ID
760600186
Effective Date
5/15/2010
Last Updated
9/29/2016
Direct Contract
Yes
Term Date
9/27/2016
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
6051 Airport Boulevard Suite A-1
Mobile, AL 36608
United States
County
Mobile
Phone
2514600201 (Phone)
Billing Details
Address
6051 Airport Boulevard
Suite A-1
Mobile, AL 36608
Billing Phone
2514600201
Specialty Type
Physical Therapy
Map
Address