Contract Details
Ancillary Care Services
Facility name
Thomasville Physical Therapy
Provider ID
P000004906
NPI
1598816290
Tax ID
581819981
Effective Date
4/1/2012
Last Updated
4/12/2018
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
88.00
Location Details
Address
1203 East Jackson Street
Thomasville, GA 31792
United States
County
Thomas
Phone
2292284155 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Physical Therapy
Map
Address