Conan    Brooks    RPT
Contract Details
Aldridge Physical Therapy, LLC
Facility name
Provider ID
P000000201
NPI
1154367365
Tax ID
260734207
Effective Date
12/15/2016
Last Updated
12/20/2016
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
74186 Tallasee Highway Suite B
Wetumpka, AL 360925643
United States
County
Elmore
Phone
3344783543 (Phone)
Billing Details
Address
430 Innovation Drive
Blairsville, PA 157178096
Billing Phone
7243434060
Specialty Type
Physical Therapy
Map
Address