Traci  M  Smith    RPT
Contract Details
Rehab Associates--Birmingham-Gold's Gym 280
Facility name
Provider ID
P000006799
NPI
1740379700
Tax ID
721379381
Effective Date
11/8/2010
Last Updated
6/5/2014
Direct Contract
Yes
Term Date
6/5/2014
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
3427 Colonnade Parkway
Birmingham, AL 35243
United States
County
Jefferson
Phone
2059692354 (Phone)
Billing Details
Address
P.O. Box 1245
Indiana, PA 15701
Billing Phone
7244653496
Specialty Type
Physical Therapy
Map
Address