Stephanie  R  Brown    RPT
Contract Details
ATI Holdings of Alabama, LLC
Facility name
Provider ID
P000007779
NPI
1255375911
Tax ID
352585937
Effective Date
5/16/2019
Last Updated
6/25/2019
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
2057303166 (Phone)
Billing Details
Address
P.O. Box 7400705
Chicago, IL 60674
Billing Phone
3602962222
Specialty Type
Physical Therapy
Map
Address