Robert  B  Poczatek    MD
Contract Details
Fast360, LLC
Facility name
Provider ID
P000001373
NPI
1447347489
Tax ID
460926698
Effective Date
1/1/2017
Last Updated
5/21/2017
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
M
Exhibit ID
AM_312
Location Details
Address
800 Saint Vincent's Drive Suite 700
Birmingham, AL 35205
United States
County
Jefferson
Phone
8666746728 (Phone)
Billing Details
Address
761 Old Hickory Boulevard
Suite 300
Brentwood, TN 37027
Billing Phone
8666746728
Specialty Type
Physical Medicine & Rehabilitation
Map
Address