Contract Details
Facility name
Advantage Physical Therapy
Provider ID
P000001943
NPI
1518036946
Tax ID
412179130
Effective Date
5/15/2006
Last Updated
4/12/2018
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
17495 Highway 75
Henagar, AL 35978
United States
County
De Kalb
Phone
2566573626 (Phone)
Billing Details
Address
P.O. Box 51
Henagar, AL 35978
Billing Phone
2566573626
Specialty Type
Physical Therapy
Map
Address