Tiffany  L  Clayton    RPT
Contract Details
Cornerstone Fitness & Wellness, LLC.
Facility name
Provider ID
P000008579
NPI
1861934002
Tax ID
631255903
Effective Date
2/16/2017
Last Updated
2/17/2017
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
110 Baker Avenue
Clanton, AL 35045
United States
County
Chilton
Phone
2052806450 (Phone)
Billing Details
Address
P.O. Box Drawer 1200
Clanton, AL 35045
Billing Phone
2052806450
Specialty Type
Physical Therapy
Map
Address