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Jane
M
Torrie
DC
Contract Details
Facility name
Provider ID
P000003676
NPI
1033425657
Tax ID
800748893
Effective Date
4/30/2012
Last Updated
10/23/2012
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
210 South Elm Suite 101
Denton, TX 76201
United States
County
Denton
Phone
9405941406
(
Phone
)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Chiropractic Medicine
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Address