Laura  E  Richardson    RPT
Contract Details
TherapySouth--Birmingham-Lakeview/Southside
Facility name
Provider ID
P000007598
NPI
1790082675
Tax ID
462152750
Effective Date
2/15/2012
Last Updated
12/19/2017
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
2823 Greystone Commercial Boulevard
Birmingham, AL 35242
Billing Phone
2054081713
Specialty Type
Physical Therapy
Map
Address