Contract Details
Align Networks, Inc.
Facility name
Southlake Orthopaedics Sports Medicine and Spine Center
Provider ID
P000002433
NPI
1518970722
Tax ID
043821114
Effective Date
4/1/2013
Last Updated
4/12/2018
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
513 Brookwood Boulevard Suite 402
Birmingham, AL 35209
United States
County
Jefferson
Phone
8663890211 (Phone)
Billing Details
Address
P.O. Box 402355
Atlanta, GA 30384
Billing Phone
8663890211
Specialty Type
Physical Therapy
Map
Address