Contract Details
A Physiotherapy Associates Company
Facility name
Champion Sports Medicine & Rehab Center - Birmingham Southern College
Provider ID
P000003350
NPI
1568742252
Tax ID
721379381
Effective Date
8/29/2011
Last Updated
4/12/2018
Direct Contract
Yes
Term Date
5/8/2014
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
900 Arkadelphia Road
Birmingham, AL 35254
United States
County
Jefferson
Phone
2052264946 (Phone)
Billing Details
Address
P.O. Box 1245
Indiana, PA 15701
Billing Phone
7244653496
Specialty Type
Physical Therapy
Map
Address