Mary  C  Peterson    RPT
Contract Details
Physiotherapy Associates
Facility name
Provider ID
P000002679
NPI
1346216678
Tax ID
382617193
Effective Date
7/21/2011
Last Updated
11/22/2011
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
1125 Schilling Blvd East Suite 104
Collierville, TN 38017
United States
County
Shelby
Phone
9018505500 (Phone)
Billing Details
Address
Specialty Type
Physical Therapy
Map
Address