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Contract Details
Facility name
Hand and Occupational Therapy Center
Provider ID
P000000001
NPI
1417256041
Tax ID
825331488
Effective Date
5/8/2018
Last Updated
8/14/2020
Direct Contract
Yes
Status
Active
W9 Attachment
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
2767 Office Park Circle
Montgomery, AL 36116
United States
Phone
334-239-9431
(
Phone
)
Billing Details
Address
2767 Office Park Circle
Montgomery, AL 36116
Billing Phone
334-239-9431
Specialty Type
Physical Therapy
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