John    Cormier    RPT
Contract Details
Southern Physical Rehab Network
Facility name
Provider ID
P000007419
NPI
1215992169
Tax ID
631105473
Effective Date
8/10/2000
Last Updated
6/9/2014
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
APTOR Physical Therapy 526 14th Street
Tuscaloosa, AL 35401
United States
County
Tuscaloosa
Phone
2053454441 (Phone)
Billing Details
Address
109 9th Street Southwest
Suite C
Cullman, AL 35055
Billing Phone
2567369926
Specialty Type
Physical Therapy
Map
Address