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
1900 South Heaton Street Units 110
Knox, IN 46534
United States
County
Starke
Phone
5747722980 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Rehabilitation Facility
Map
Address