Contract Details
A Physiotherapy Associates Company
Facility name
Champion Sports Medicine
Provider ID
P000008627
NPI
1356885156
Tax ID
721379381
Effective Date
1/3/2017
Last Updated
4/12/2018
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
1837 Patriots Way
Cullman, AL 35055
United States
County
Cullman
Phone
2567754421 (Phone)
Billing Details
Address
P.O. Box 1245
Indiana, PA 15701
Billing Phone
7244653496
Specialty Type
Physical Therapy
Map
Address