James  H  Warren    RPT
Contract Details
IPT--Birmingham-Homewood
Facility name
Provider ID
P000007408
NPI
1649589003
Tax ID
454446228
Effective Date
8/1/2013
Last Updated
11/8/2016
Direct Contract
Yes
Term Date
11/8/2016
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
70.00
Location Details
Address
120-B Oxmoor Court
Birmingham, AL 35209
United States
County
Jefferson
Phone
2052992146 (Phone)
Billing Details
Address
120-B Oxmoor Court
Birmingham, AL 35209
Billing Phone
2052992146
Specialty Type
Physical Therapy
Map
Address