Contract Details
Ancillary Care Services
Facility name
Select Physical Therapy
Provider ID
P000005640
NPI
1932109071
Tax ID
592922487
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
11930 Boyette Road
Riverview, FL 33569
United States
County
Hillsborough
Phone
8136711022 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Rehabilitation Facility
Map
Address