Ryan    Huff    RPT
Contract Details
ATI Holdings of Alabama, LLC
Facility name
Provider ID
P000008765
NPI
1841420874
Tax ID
352585937
Effective Date
6/19/2017
Last Updated
6/19/2017
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
75.00
Location Details
Address
735 Park Avenue NW
Jacksonville, AL 36265
United States
County
Calhoun
Phone
6302962223 (Phone)
Billing Details
Address
P.O. Box 74008705
Chicago, IL 60674
Billing Phone
3602962222
Specialty Type
Physical Therapy
Map
Address