Provider Demographics
NPI:1720318298
Name:ATI HOLDINGS LLC
Entity Type:Organization
Organization Name:ATI HOLDINGS LLC
Other - Org Name:PRO PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CREDENTIALING SPECIALIST
Authorized Official - Prefix:MR
Authorized Official - First Name:KRISTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:ACHUFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-793-0432
Mailing Address - Street 1:1208 KIRKWOOD HIGHWAY
Mailing Address - Street 2:STE 1
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19805-1844
Mailing Address - Country:US
Mailing Address - Phone:302-993-1450
Mailing Address - Fax:302-993-1454
Practice Address - Street 1:1812 MARSH RD
Practice Address - Street 2:STE 505
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19810-4581
Practice Address - Country:US
Practice Address - Phone:302-793-0432
Practice Address - Fax:302-793-0400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-06
Last Update Date:2010-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE4564545OtherAETNA
DE21460OtherUNISON
DEDF8714OtherRAILROAD MEDICARE
DE0349877000OtherIBC
DE1000040229Medicaid
DE908121OtherPA B/S
DEG02378Medicare PIN