Brian  M  Williams    RPT
Contract Details
Advantage Physical Therapy
Facility name
Provider ID
P000007510
NPI
1124121025
Tax ID
412179130
Effective Date
5/15/2006
Last Updated
5/21/2017
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
17495 Highway 75
Henagar, AL 35978
United States
County
De Kalb
Phone
2566573626 (Phone)
Billing Details
Address
17495 Highway 75
Henagar, AL 35978
Billing Phone
2566573626
Specialty Type
Physical Therapy
Map
Address