Kellie  A  Corder    PA-C
Contract Details
The Spine & Neuro Center
Facility name
Provider ID
P000003521
NPI
1962715516
Tax ID
630572198
Effective Date
1/14/2002
Last Updated
5/10/2017
Direct Contract
Yes
Term Date
5/7/2017
Status
Contract Discounts
Discount Type
F
Fee Schedule Name
103.00
Fee Schedule Multiplier
Location Details
Address
201 Governors Drive
Huntsville, AL 35801
United States
County
Madison
Phone
2565331600 (Phone)
Billing Details
Address
201 Governors Drive
Huntsville, AL 35801
Billing Phone
2565331600
Specialty Type
Physician Assistant
Map
Address