Name: PRO IMPACT PT & SPORTS PERFORMANCE
Address: 635 MCQUEEN SMITH RD N, Prattville, 36066-5660, United States
Telephone: 866-214-5920

Contract Details

Direct Pay Provider Network

Facility name

PRO IMPACT PT & SPORTS PERFORMANCE

Provider ID

P000000001

Tax ID

273151360

Effective Date

8/28/2023

Direct Contract

Status

Active

Contract Discounts

Discount Type

Exhibit ID

AM_522

Location Details

Address

635 MCQUEEN SMITH RD N

Prattville, AL 36066-5660

United States

Phone

866-214-5920 (Phone)

Billing Details

Address

P.O. Box 1177

Fairhope, AL 36533

Specialty Type

Physical Therapy

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