Oscar    Andalon    RPT
Contract Details
Ancillary Care Services
Facility name
Provider ID
P000005252
NPI
1750312971
Tax ID
261171845
Effective Date
4/1/2012
Last Updated
9/27/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
92.00
Location Details
Address
215 Lighthouse Terrace
Franklin, TN 37064
United States
County
Williamson
Phone
6155915592 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Physical Therapy
Map
Address