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Contract Details
Facility name
Select Physical Therapy
Provider ID
631133454
Tax ID
631133454
Effective Date
2/1/2020
Last Updated
7/29/2021
Direct Contract
Yes
Term Date
5/28/2021
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
365 South Hartman Suite 102
Lebanon, TN 37087
United States
Phone
615-444-0854
(
Phone
)
Fax
615-235-1404
Billing Details
Address
365 South Hartman
Suite 102
Dallas, TX 37087
Billing Phone
615-444-0854
Specialty Type
Physical Therapy
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