Kaitlyn    Revette    RPT
Contract Details
Northeast Orthopedic Clinic
Facility name
Provider ID
P000000001
NPI
1316425234
Tax ID
631081989
Effective Date
5/3/2017
Last Updated
6/28/2022
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
507 South 4th Street
Gadsden, AL 35901
United States
Phone
256-456-0563 (Phone)
Billing Details
Address
507 South 4th Street
Gadsden, AL 35901
Billing Phone
256-547-7417
Specialty Type
Physical Therapy
Map
Address