Contract Details
Facility name
Mobile Spine & Rehabilitation Center
Provider ID
P000003392
NPI
1447361407
Tax ID
760600186
Effective Date
5/15/2010
Last Updated
4/12/2018
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
6051 Airport Boulevard Suite A-1
Mobile, AL 36608
United States
County
Mobile
Phone
2514600201 (Phone)
Billing Details
Address
1300 W. Sam Houston Parkway South
Suite 300
Houston, TX 77042
Billing Phone
7132977000
Specialty Type
Physical Therapy
Map
Address