Jessica    Munk    RPT
Contract Details
HealthActions
Facility name
Provider ID
P000000001
NPI
1487251823
Tax ID
630815380
Effective Date
3/17/2022
Last Updated
3/18/2022
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
1109 Boll Weevil Circle Suite 2
Enterprise, AL 36330
United States
Phone
334-828-7591 (Phone)
Billing Details
Address
1711 College Avenue
P.O. Box 37
Jackson, AL 36545
Billing Phone
251-246-5761
Specialty Type
Physical Therapy
Map
Address