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John
R
Sass
PHD
Contract Details
Restore Health Group, Inc
Facility name
Provider ID
P000002684
NPI
1093858854
Tax ID
582569093
Effective Date
12/15/2010
Last Updated
2/12/2021
Direct Contract
Yes
Status
Active
W9 Attachment
Contract Discounts
Discount Type
BC
Billed Charges Multiplier
85.00
Location Details
Address
11775 Pointe Place Suite 103
Roswell, GA 30076
United States
County
Fulton
Phone
7706190010
(
Phone
)
Billing Details
Address
11775 Pointe Place
Suite 103
Roswell, GA 30076
Billing Phone
770-619-0010
Specialty Type
Neuropsychology
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Address