Contract Details
Ancillary Care Services
Facility name
Select Physical Therapy
Provider ID
P000004424
NPI
1396745063
Tax ID
232736153
Effective Date
4/1/2012
Last Updated
10/11/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
92.00
Location Details
Address
4932 Southpoint Parkway
Fredericksburg, VA 22407
United States
County
Spotsylvania
Phone
5408911186 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Rehabilitation Facility
Map
Address