Valerie  L  Hathcock    RPT
Contract Details
Physiotherapy Associates
Facility name
Provider ID
P000002655
NPI
1922024397
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
3108 North Germantown Pkwy Suite 106 & 107
Bartlett, TN 38133
United States
County
Shelby
Phone
9013834515 (Phone)
Billing Details
Address
Specialty Type
Physical Therapy
Map
Address