Christopher    Hyde    DC
Contract Details
Ancillary Care Services
Facility name
Provider ID
P000003614
NPI
1003984113
Tax ID
061768315
Effective Date
4/1/2012
Last Updated
10/21/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
5650 West 86th Street Suite 128
Carmel, IN 46032
United States
County
Hamilton
Phone
3178709912 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Chiropractic Medicine
Map
Address