Contract Details
Academy Orthotic & Prosthetic Associates
Facility name
Academy / Bay Ortho & Rehab
Provider ID
P000006370
Tax ID
113193924
Effective Date
4/1/2012
Last Updated
10/23/2012
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
92.00
Location Details
Address
1145 Montauk Hwy
West Islip, NY 11795
United States
County
Suffolk
Phone
8006692672 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Orthotics/Prosthetics, Services
Map
Address