Contract Details
Ancillary Care Services
Facility name
Thomas Physical & Hand Therapy
Provider ID
P000006174
Tax ID
760528480
Effective Date
4/1/2012
Last Updated
10/16/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
92.00
Location Details
Address
10320 Mallard Creek Road Suite 275
Charlotte, NC 28262
United States
County
Mecklenburg
Phone
7045499322 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Rehabilitation Facility
Map
Address