Patrick    Garofano    RPT
Contract Details
Fairhope Physical Therapy Services
Facility name
Provider ID
P000009051
NPI
1255389797
Tax ID
721355610
Effective Date
1/19/2018
Last Updated
1/24/2018
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
75.00
Location Details
Address
243 S. Greeno Road
Fairhope, AL 36532
United States
County
Baldwin
Phone
2519283909 (Phone)
Billing Details
Address
243 S. Greeno Road
Fairhope, AL 36532
Billing Phone
2519283909
Specialty Type
Physical Therapy
Map
Address