Jason    Harris    RPT
Contract Details
Aldridge Physical Therapy, LLC
Facility name
Provider ID
P000000718
NPI
1518901909
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
4810 Woods Crossing Drive
Montgomery, AL 361063650
United States
County
Montgomery
Phone
3342399316 (Phone)
Billing Details
Address
430 Innovation Drive
Blairsville, PA 157178096
Billing Phone
7243434060
Specialty Type
Physical Therapy
Map
Address