Mary Katherine    Graham    RPT
Contract Details
P4 Physical Therapy
Facility name
Provider ID
P000000001
NPI
1609652668
Tax ID
883148972
Effective Date
9/6/2023
Last Updated
7/2/2024
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
75.00
Location Details
Address
15641 E Limestone Road
Athens, AL 35613
United States
Phone
256-867-0100 (Phone)
Billing Details
Address
15641 E Limestone Road
Athens, AL 35613
Billing Phone
256-867-0100
Specialty Type
Physical Therapy
Map
Address