Jennifer    Davis    RPT
Contract Details
ATI Holdings of Alabama, LLC
Facility name
Provider ID
P000009018
NPI
1104023225
Tax ID
352585937
Effective Date
7/12/2017
Last Updated
11/29/2017
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
75.00
Location Details
Address
76359 AL Highway 77 Suite B
Lincoln, AL 35096
United States
County
Talladega
Phone
2056665511 (Phone)
Billing Details
Address
P.O. Box 74008705
Chicago, IL 60674
Billing Phone
3602962222
Specialty Type
Physical Therapy
Map
Address