Shirley  S  Ballard    OTR
Contract Details
Hand and Occupational Therapy Center
Facility name
Provider ID
P000008020
NPI
1588660070
Tax ID
825331488
Effective Date
8/1/2014
Last Updated
8/14/2020
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
2767 Office Park Circle
Montgomery, AL 36116
United States
County
Montgomery
Phone
3342399431 (Phone)
Billing Details
Address
2767 Office Park Circle
Montgomery, AL 36116
Billing Phone
3342399431
Specialty Type
Occupational Therapy
Map
Address