Kayleigh    Duprel    RPT
Contract Details
ATI Physical Therapy
Facility name
Provider ID
P000000001
NPI
1063952646
Tax ID
352585937
Effective Date
12/13/2024
Last Updated
12/17/2024
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
75.00
Location Details
Address
4825 Montgomery Highway Suite 103
Dothan, AL 36303
United States
Phone
334-500-1139 (Phone)
Billing Details
Address
P.O. Box 74008705
Chicago, IL 60674
Billing Phone
360-296-2222
Specialty Type
Physical Therapy
Map
Address