Sarah  A  Ward    RPT
Contract Details
Physiotherapy Associates
Facility name
Provider ID
P000002695
NPI
1528236072
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
8507 Hwy 51 Suite 107
Millington, TN 38053
United States
County
Shelby
Phone
9018733773 (Phone)
Billing Details
Address
Specialty Type
Physical Therapy
Map
Address