Margaret    Quinn    RPT
Contract Details
P4 Physical Therapy
Facility name
Provider ID
P000000001
NPI
1326670654
Tax ID
883148972
Effective Date
12/28/2022
Last Updated
1/6/2023
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
75.00
Location Details
Address
2244 North Road Suite 104
Gardendale, AL 35071
United States
Phone
205-418-1080 (Phone)
Billing Details
Address
8059 Mitchell Lane
Birmingham, AL 35216
Billing Phone
205-607-0632
Specialty Type
Physical Therapy
Map
Address