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
3400 North Lecanto Highway Suite B
Beverly Hills, FL 34465
United States
County
Citrus
Phone
3525278489 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Rehabilitation Facility
Map
Address