Contract Details
Ancillary Care Services
Facility name
Coastal Therapy
Provider ID
P000004329
NPI
1346366796
Tax ID
582589781
Effective Date
4/1/2012
Last Updated
4/12/2018
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
84.00
Location Details
Address
911 East 70th Street
Savannah, GA 31405
United States
County
Chatham
Phone
9122611002 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Physical Therapy
Map
Address