Abby    Hall    OTR
Contract Details
TherapySouth
Facility name
Provider ID
P000000001
NPI
1407448004
Tax ID
208098768
Effective Date
2/15/2012
Last Updated
2/14/2022
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
125 Stephen J White Memorial Blvd
Talladega, AL 35160
United States
Phone
256-315-9693 (Phone)
Billing Details
Address
125 Stephen J White Memorial Blvd
Talladega, AL 35160
Billing Phone
256-315-9693
Specialty Type
Occupational Therapy
Website
Visit Website
Workers Comp Coordinator
Mary
Holden
mholden@therapysouth.net
Map
Address