Contract Details
Facility name
Mobile Physical Medicine & Wellness
Provider ID
P000006847
NPI
1992002356
Tax ID
274511677
Effective Date
4/23/2013
Last Updated
8/14/2014
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
90.00
Location Details
Address
273 Azalea Road Building 2, Suite 100
Mobile, AL 36609
United States
County
Mobile
Phone
2514508044 (Phone)
Billing Details
Address
273 Azalea Road
Building 2, Suite 100
Mobile, AL 36609
Billing Phone
2514508044
Specialty Type
Physical Medicine & Rehabilitation
Map
Address