Contract Details
Ancillary Care Services
Facility name
Select Physical Therapy
Provider ID
P000004753
NPI
1538164611
Tax ID
650366467
Effective Date
4/1/2012
Last Updated
10/2/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
92.00
Location Details
Address
20295 Northeast 29th Place Suite 301
Aventura, FL 33180
United States
County
Miami-Dade
Phone
3059354551 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Rehabilitation Facility
Map
Address