Ginger    Hall    RPT
Contract Details
Facility name
Provider ID
P000000001
NPI
1225227788
Tax ID
264585533
Effective Date
12/8/2023
Last Updated
12/11/2023
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
75.00
Location Details
Address
4466A Jeff Road
Toney, AL 35773
United States
Phone
256-213-1917 (Phone)
Billing Details
Address
4466A Jeff Road
Toney, AL 35773
Billing Phone
256-213-1917
Specialty Type
Physical Therapy
Map
Address