Pam    Porter    RPT
Contract Details
Align Networks, Inc.
Facility name
Provider ID
P000007162
NPI
1508940230
Tax ID
043821114
Effective Date
4/1/2013
Last Updated
2/18/2014
Direct Contract
No
Term Date
2/18/2014
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
Progressive Rehab Services 1207 Main Street
Daphne, AL 36526
United States
County
Baldwin
Phone
8663890211 (Phone)
Billing Details
Address
P.O. Box 402355
Atlanta, GA 30384
Billing Phone
8663890211
Specialty Type
Physical Therapy
Map
Address