Contract Details
Facility name
Elite Rehab
Provider ID
P000000001
NPI
1033782701
Tax ID
871247226
Effective Date
9/7/2023
Last Updated
9/14/2023
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
75.00
Location Details
Address
1258 Main Street South Suite 3
Wedowee, AL 36278
United States
Phone
256-357-1077 (Phone)
Billing Details
Address
1258 Main Street South
Suite 3
Wedowee, AL 36278
Billing Phone
256-357-1077
Specialty Type
Physical Therapy
Website
Visit Website
Map
Address