Riley    Richburg    RPT
Contract Details
Health Actions Physical Therapy
Facility name
Provider ID
P000000001
NPI
1265151948
Tax ID
630815380
Effective Date
8/25/2022
Last Updated
8/29/2022
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
1207 Ross Clark Circle
Dothan, AL 36301
United States
Phone
334-500-1150 (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