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Leslea
Shamp
RPT
Contract Details
TherapySouth--Birmingham-Lakeview/Southside
Facility name
Provider ID
P000007542
NPI
1073516506
Tax ID
462152750
Effective Date
2/15/2012
Last Updated
11/6/2013
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
720 32nd Street South
Birmingham, AL 35233
United States
County
Jefferson
Phone
2057312177
(
Phone
)
Billing Details
Address
720 32nd Street South
Birmingham, AL 35233
Billing Phone
2057312177
Specialty Type
Physical Therapy
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