Elizabeth    Lehrter    RPT
Contract Details
Eastern Shore Physical Therapy
Facility name
Provider ID
P000000001
NPI
1346568771
Tax ID
630997518
Effective Date
8/6/2020
Last Updated
8/13/2020
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
6475 Van Buren Street Suite 102
Daphne, AL 36526
United States
Phone
251-626-9052 (Phone)
Billing Details
Address
6475 Van Buren Street
Suite 102
Daphne, AL 36526
Billing Phone
251-626-9052
Specialty Type
Physical Therapy
Map
Address