Deborah    Bailey    RPT
Contract Details
Southern Physical Rehab Network
Facility name
Provider ID
P000007434
NPI
1932209541
Tax ID
205370140
Effective Date
1/1/2009
Last Updated
6/9/2014
Direct Contract
Yes
Term Date
11/6/2013
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
Therapy South--Birmingham-Hoover 3421 South Shades Crest Road, Suite 107
Birmingham, AL 35244
United States
County
Jefferson
Phone
2059876501 (Phone)
Billing Details
Address
109 9th Street Southwest
Suite C
Cullman, AL 35055
Billing Phone
2567369926
Specialty Type
Physical Therapy
Map
Address