Stacey    Sargent    RPT
Contract Details
P4 Physical Therapy
Facility name
Provider ID
P000000001
NPI
1568195386
Tax ID
883148972
Effective Date
11/27/2023
Last Updated
11/28/2023
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
75.00
Location Details
Address
1646 Town Square SW
Cullman, AL 35055
United States
Phone
256-887-4400 (Phone)
Billing Details
Address
1646 Town Square SW
Cullman, AL 35055
Billing Phone
256-887-4400
Specialty Type
Physical Therapy
Map
Address