Kelley    Kittrell-Davis    OTR
Contract Details
Physiotherapy Associates
Facility name
Provider ID
P000002666
NPI
1730282864
Tax ID
382617193
Effective Date
10/12/2011
Last Updated
11/22/2011
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
118 Brown Ave Suite 104
Crossville, TN 38555
United States
County
Cumberland
Phone
9314566608 (Phone)
Billing Details
Address
Specialty Type
Occupational Therapy
Map
Address