Contract Details
A Physiotherapy Associates Company
Facility name
Champion Sports Medicine - Closed
Provider ID
P000007626
NPI
1861825796
Tax ID
721379381
Effective Date
2/1/2006
Last Updated
4/23/2024
Direct Contract
Yes
Term Date
1/31/2024
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
3143 Pelham Parkway Suite 400
Pelham, AL 35124
United States
County
Shelby
Phone
2056643197 (Phone)
Billing Details
Address
3143 Pelham Parkway
Suite 400
Indiana, PA 35124
Billing Phone
7244653496
Specialty Type
Physical Therapy
Map
Address