Contract Details
Dadeville Sports Medicine & Physical Therapy
Facility name
Lake Martin Physical Therapy
Provider ID
P000003386
NPI
1699895490
Tax ID
721379419
Effective Date
1/20/2017
Last Updated
4/12/2018
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
1120 Airport Drive Suite 103
Alexander City, AL 35010
United States
County
Tallapoosa
Phone
2563298180 (Phone)
Billing Details
Address
1120 Airport Drive
Suite 103
Alexander City, AL 35010
Billing Phone
2563298180
Specialty Type
Physical Therapy
Map
Address