Contract Details
American Prosthetics & Orthotics
Facility name
Modern Rehab
Provider ID
P000006283
Tax ID
900427698
Effective Date
4/1/2012
Last Updated
10/23/2012
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
329 Middle Country Rd Building A, Suite 2
Smithtown, NY 11787
United States
County
Suffolk
Phone
9175927277 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Orthotics/Prosthetics, Services
Map
Address