Contract Details
Ancillary Care Services
Facility name
Select Physical Therapy
Provider ID
P000004296
NPI
1336149848
Tax ID
582304502
Effective Date
4/1/2012
Last Updated
10/17/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
92.00
Location Details
Address
910 Johnnie Dodds Boulevard
Mount Pleasant, SC 29464
United States
County
Charleston
Phone
8439710291 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Rehabilitation Facility
Map
Address