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Tonia
M
Matwijczuk
RPT
Contract Details
Physiotherapy Associates
Facility name
Provider ID
P000002672
NPI
1750406419
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
104 Glen Oak Blvd Suite 120
Hendersonville, TN 37075
United States
County
Sumner
Phone
6153384391
(
Phone
)
Billing Details
Address
Specialty Type
Physical Therapy
Map
Address