Joseph    Lowery    RPT
Contract Details
ATI Holdings of Alabama, LLC
Facility name
Provider ID
P000009131
NPI
1992111512
Tax ID
352585937
Effective Date
5/14/2018
Last Updated
4/23/2018
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
75.00
Location Details
Address
1451 Dr Edward Hillard Drive Suite 130
Tuscaloosa, AL 35401
United States
County
Tuscaloosa
Phone
2055615899 (Phone)
Billing Details
Address
P.O. Box 74008705
Chicago, IL 60674
Billing Phone
3602962222
Specialty Type
Physical Therapy
Map
Address