Scott    Deuel    RPT
Contract Details
Southern Physical Rehab Network
Facility name
Provider ID
P000007420
NPI
1457431272
Tax ID
631254633
Effective Date
2/15/2005
Last Updated
6/9/2014
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
Back In Motion Physical Therapy 6460 Highway 11
Springville, AL 35146
United States
County
Saint Clair
Phone
2054679298 (Phone)
Billing Details
Address
109 9th Street Southwest
Suite C
Cullman, AL 35055
Billing Phone
2567369926
Specialty Type
Physical Therapy
Map
Address