Keith  C  Anderson    DO
Contract Details
Fast360, LLC
Facility name
Provider ID
P000000039
NPI
1982763165
Tax ID
460926698
Effective Date
1/1/2017
Last Updated
3/23/2020
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
M
Exhibit ID
AM_312
Location Details
Address
201 Governors Drive 1st Floor
Huntsville, AL 35801
United States
County
Madison
Phone
8666746728 (Phone)
Billing Details
Address
201 Governors Drive
1st Floor
Brentwood, TN 35801
Billing Phone
8666746728
Specialty Type
Physical Medicine & Rehabilitation
Map
Address