Contract Details
A Physiotherapy Associates Company
Facility name
Champion Sports Medicine - Hand Therapy
Provider ID
P000008198
NPI
1730578295
Tax ID
721379381
Effective Date
2/4/2015
Last Updated
3/24/2021
Direct Contract
Yes
Term Date
3/24/2021
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
805 St. Vincent's Drive Suite A
Birmingham, AL 35205
United States
County
Jefferson
Phone
2052129435 (Phone)
Billing Details
Address
805 St. Vincent's Drive
Suite A
Birmingham, AL 35205
Billing Phone
2052129435
Specialty Type
Physical Therapy
Map
Address