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Kendell
Finn
RPT
Contract Details
M3 Endeavor
Facility name
Provider ID
P000009269
NPI
1720557085
Tax ID
473586611
Effective Date
12/12/2018
Last Updated
9/22/2023
Direct Contract
Yes
Status
Active
W9 Attachment
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
75.00
Location Details
Address
8331 Gadsden Highway
Trussville, AL 35173
United States
County
Jefferson
Phone
205-613-6675
(
Phone
)
Billing Details
Address
8331 Gadsden Highway
Trussville, AL 35173
Billing Phone
205-613-6675
Specialty Type
Physical Therapy
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Address