Contract Details
Ancillary Care Services
Facility name
Select Physical Therapy
Provider ID
P000005217
NPI
1730183153
Tax ID
592202550
Effective Date
4/1/2012
Last Updated
10/1/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
92.00
Location Details
Address
5827 Highway 90
Milton, FL 32583
United States
County
Santa Rosa
Phone
8509838583 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Rehabilitation Facility
Map
Address