Contract Details
Ancillary Care Services
Facility name
Select Physical Therapy
Provider ID
P000004624
NPI
1477559771
Tax ID
561818102
Effective Date
4/1/2012
Last Updated
10/16/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
92.00
Location Details
Address
3060 Henderson Drive
Jacksonville, NC 28546
United States
County
Onslow
Phone
9103463151 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Rehabilitation Facility
Map
Address