Nathaniel    Sparkman    RPT
Contract Details
ATI Holdings of Alabama
Facility name
Provider ID
P000009382
NPI
1740840123
Tax ID
352585937
Effective Date
8/1/2019
Last Updated
8/13/2019
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
75.00
Location Details
Address
1811 Hwy 78 Suite 108 & 109
Jasper, AL 35501
United States
County
Walker
Phone
2052828445 (Phone)
Billing Details
Address
P.O. Box 74008705
Chicago, IL 60674
Billing Phone
3602962222
Specialty Type
Physical Therapy
Map
Address