Leslie    Davis    OTR
Contract Details
Baldwin Bone & Joint
Facility name
Provider ID
P000000001
NPI
1386025476
Tax ID
631283588
Effective Date
11/18/2022
Last Updated
11/21/2022
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
M
Exhibit ID
AM_489
Location Details
Address
1505 Daphne Avenue
Daphne, AL 36526
United States
Phone
251-625-2663 (Phone)
Billing Details
Address
1505 Daphne Avenue
Daphne, AL 36526
Billing Phone
251-625-2663
Specialty Type
Occupational Therapy Facility
Map
Address