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Contract Details
Facility name
Star Physical Therapy
Provider ID
P000000001
NPI
1396704094
Tax ID
621707893
Effective Date
12/15/2023
Last Updated
1/22/2024
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
75.00
Location Details
Address
585 Interstate Drive Suite A
Manchester, TN 37355
United States
Phone
931-723-7156
(
Phone
)
Fax
931-723-7159
Billing Details
Address
585 Interstate Drive
Suite A
Manchester, TN 37355
Billing Phone
931-723-7156
Specialty Type
Physical Therapy
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