Christy  K  Dutton    RPT
Contract Details
HealthWorx
Facility name
Provider ID
P000007595
NPI
1659337327
Tax ID
452197019
Effective Date
3/28/2012
Last Updated
6/20/2017
Direct Contract
Yes
Term Date
6/18/2017
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
78.00
Location Details
Address
2124 4th Avenue South Suite 210
Birmingham, AL 35233
United States
County
Jefferson
Phone
2054272996 (Phone)
Billing Details
Address
P.O. Box 660346
Birmingham, AL 35266
Billing Phone
2054272996
Specialty Type
Physical Therapy
Map
Address