Name: RESTORE - OUTPATIENT OF MOUNDVILLE
Address: 39546 AL HIGHWAY 69 STE F, Moundville, 35474-4367, United States
Telephone: 866-214-5920

Contract Details

Direct Pay Provider Network

Facility name

RESTORE - OUTPATIENT OF MOUNDVILLE

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

39546 AL HIGHWAY 69 STE F

Moundville, AL 35474-4367

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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