Billy    Garrett    RPT
Contract Details
P4 Physical Therapy
Facility name
Provider ID
P000000001
NPI
1134903842
Tax ID
883148972
Effective Date
10/6/2023
Last Updated
10/9/2023
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
75.00
Location Details
Address
385 Bryan Road Suite 360
Sumiton, AL 35148
United States
Phone
205-737-1800 (Phone)
Billing Details
Address
8059 Mitchell Lane
Birmingham, AL 35216
Billing Phone
205-607-0632
Specialty Type
Physical Therapy
Map
Address