Joseph  M  Tucker    RPT
Contract Details
LifeWork Therapy Services
Facility name
Provider ID
P000008776
NPI
1760640072
Tax ID
815052804
Effective Date
12/23/2017
Last Updated
6/25/2018
Direct Contract
Yes
Term Date
6/22/2018
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
913 Highway 31 SW
Hartselle, AL 35640
United States
County
Morgan
Phone
2565028684 (Phone)
Billing Details
Address
913 Highway 31 SW
Hartselle, AL 35640
Billing Phone
2565028684
Specialty Type
Physical Therapy
Map
Address