David    Bledsoe    OTR
Contract Details
Align Networks, Inc.
Facility name
Provider ID
P000007131
NPI
1538176839
Tax ID
043821114
Effective Date
4/1/2013
Last Updated
3/3/2014
Direct Contract
No
Term Date
3/3/2014
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
Bledsoe Occupational Therapy 272 Snow Drive
Birmingham, AL 35209
United States
County
Jefferson
Phone
8663890211 (Phone)
Billing Details
Address
P.O. Box 402355
Atlanta, GA 30384
Billing Phone
8663890211
Specialty Type
Occupational Therapy
Map
Address