Catherine  C  Bonner    RPT
Contract Details
Southern Physical Rehab Network
Facility name
Provider ID
P000000168
NPI
1417067448
Tax ID
205395626
Effective Date
12/5/2006
Last Updated
6/9/2014
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
TherapySouth--Birmingham-Greystone 2807 Greystone Commercial Bouelvard
Birmingham, AL 35242
United States
County
Shelby
Phone
2054081713 (Phone)
Billing Details
Address
109 9th Street Southwest
Suite C
Cullman, AL 35055
Billing Phone
2567369926
Specialty Type
Physical Therapy
Map
Address