Contract Details
Direct Pay Provider Network
Facility name
HEALTHSOURCE
Provider ID
P000000001
Tax ID
273151360
Effective Date
8/28/2023
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
M
Exhibit ID
AM_522
Location Details
Address
1207 E FORREST ST STE A
Athens, AL 35613-2058
United States
Phone
866-214-5920 (Phone)
Billing Details
Address
P.O. Box 1177
Fairhope, AL 36533
Specialty Type
Physical Therapy
Website
Visit Website
Map
Address