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Contract Details
Ancillary Care Services
Facility name
Onsite Rehab
Provider ID
P000005945
Tax ID
582273537
Effective Date
4/1/2012
Last Updated
4/12/2018
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
84.00
Location Details
Address
18 Riverbend Drive Southwest Suite 100
Rome, GA 30161
United States
County
Floyd
Phone
4048752323
(
Phone
)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Physical Therapy
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Address