Contract Details
Ancillary Care Services
Facility name
Select Physical Therapy
Provider ID
P000004780
NPI
1548260193
Tax ID
582342213
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
2726 Electric Road Suite 101
Roanoke, VA 24018
United States
County
Roanoke
Phone
5409898974 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Rehabilitation Facility
Map
Address