Patrick    Prewitt    RPT
Contract Details
ATI Physical Therapy
Facility name
Provider ID
P000009255
NPI
1174092704
Tax ID
352585937
Effective Date
11/7/2018
Last Updated
11/15/2018
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
75.00
Location Details
Address
636 Montgomery Highway
Vestavia, AL 35216
United States
County
Jefferson
Phone
2055082277 (Phone)
Billing Details
Address
P.O. Box 74008705
Chicago, IL 60674
Billing Phone
3602962222
Specialty Type
Physical Therapy
Map
Address