Organization
ATI HOLDINGS LLC
Active
Other names
PRO Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KRISTIN ACHUFF (CREDENTIALING SPECIALIST)
(302) 793-0432
Entity
Organization
Contact information
Practice address
1812 MARSH RD, STE 505, WILMINGTON, DE 19810-4581
(302) 793-0432
(302) 793-0400
Mailing address
1208 KIRKWOOD HIGHWAY, STE 1, WILMINGTON, DE 19805-1844
(302) 993-1450
(302) 993-1454
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0349877000
IBC
DE
05
—
1000040229
—
DE
01
—
21460
UNISON
DE
01
—
4564545
AETNA
DE
01
—
908121
PA B/S
DE
01
—
DF8714
RAILROAD MEDICARE
DE
Enumeration date
01/06/2010
Last updated
01/06/2010
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