Contract Details
A Physiotherapy Associates Company
Facility name
Champion Sports Medicine & Rehabilitation Center - Livingston
Provider ID
P000002041
NPI
1982813234
Tax ID
721379381
Effective Date
2/1/2006
Last Updated
4/12/2018
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
1 College Drive
Livingston, AL 35470
United States
County
Sumter
Phone
2056523714 (Phone)
Billing Details
Address
P.O. Box 1245
Indiana, PA 15701
Billing Phone
7244653496
Specialty Type
Physical Therapy
Map
Address