Contract Details
Ancillary Care Services
Facility name
Select Physical Therapy
Provider ID
P000005001
NPI
1649270943
Tax ID
541323120
Effective Date
4/1/2012
Last Updated
10/14/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
92.00
Location Details
Address
320B Charles H. Dimmock Parkway Suite C
Colonial Heights, VA 23834
United States
County
Colonial Heights Cty
Phone
8045240533 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Rehabilitation Facility
Map
Address