Kimberly    Edison    OTR
Contract Details
TherapySouth
Facility name
Provider ID
P000000001
NPI
1689057507
Tax ID
463895719
Effective Date
2/15/2012
Last Updated
2/9/2022
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
1530 East Glenn Avenue
Auburn, AL 36830
United States
Phone
334-502-7839 (Phone)
Billing Details
Address
2823 Greystone Commercial Blvd
Birmingham, AL 35242
Billing Phone
205-745-3660
Specialty Type
Occupational Therapy
Website
Visit Website
Workers Comp Coordinator
Mary
Holden
mholden@therapysouth.net
Map
Address