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Contract Details
Southern Physical Rehab Network
Facility name
Provider ID
P000007432
NPI
1538191648
Tax ID
631193409
Effective Date
1/1/1997
Last Updated
6/9/2014
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
Tallassee Rehab 1000 Friendship Road
Tallassee, AL 36078
United States
County
Elmore
Phone
3342838032 (Phone)
Billing Details
Address
109 9th Street Southwest
Suite C
Cullman, AL 35055
Billing Phone
2567369926
Specialty Type
Physical Therapy
Map
Address