Contract Details
Ancillary Care Services
Facility name
Select Physical Therapy
Provider ID
P000004260
NPI
1316942394
Tax ID
351436134
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
3830 Shore Drive
Indianapolis, IN 46254
United States
County
Marion
Phone
3172989746 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Rehabilitation Facility
Map
Address