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Contract Details
Facility name
Brooks Rehabilitation
Provider ID
P000000001
NPI
1669039400
Tax ID
592249372
Effective Date
2/13/2020
Last Updated
12/13/2022
Direct Contract
Yes
Status
Active
W9 Attachment
Contract Discounts
Discount Type
M
Exhibit ID
AM_440
Exhibit Attachment
Location Details
Address
463721 SR 200 Suite 7
Yulee, FL 32097
United States
Phone
904-602-6088
(
Phone
)
Fax
904-602-6091
Billing Details
Address
463721 SR 200
Suite 7
Yulee, FL 32097
Billing Phone
904-602-6088
Specialty Type
Physical Therapy
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