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Contract Details
Northeast Orthopedic Clinic, PC
Facility name
Northeast Orthopedics
Provider ID
P000002280
NPI
1699785790
Tax ID
631081989
Effective Date
5/3/2017
Last Updated
4/12/2018
Direct Contract
Yes
Status
Active
W9 Attachment
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
507 South 4th Street
Gadsden, AL 35901
United States
County
Etowah
Phone
2564560563
(
Phone
)
Billing Details
Address
507 South 4th Street
Gadsden, AL 35901
Billing Phone
2565477417
Specialty Type
Physical Therapy
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Address