Contract Details
Ancillary Care Services
Facility name
Select Physical Therapy
Provider ID
P000003877
NPI
1134124118
Tax ID
251883131
Effective Date
4/1/2012
Last Updated
10/21/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
92.00
Location Details
Address
50 Nichols Street
Hebron, IN 46341
United States
County
Porter
Phone
2199965695 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Rehabilitation Facility
Map
Address