Contract Details
Facility name
TherapySouth Mountain Brook
Provider ID
P000003443
NPI
1699910505
Tax ID
263761856
Effective Date
2/15/2012
Last Updated
4/12/2018
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
205 Country Club Park
Birmingham, AL 35213
United States
County
Jefferson
Phone
2058710777 (Phone)
Billing Details
Address
205 Country Club Park
Birmingham, AL 35213
Billing Phone
2058710777
Specialty Type
Physical Therapy
Map
Address