Darren  C  Campbell    DC
Contract Details
Facility name
Provider ID
P000003858
NPI
1124099320
Tax ID
200008385
Effective Date
4/1/2012
Last Updated
10/23/2012
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
100 South 4th Ave Suite 4
Eldridge, IA 52748
United States
County
Scott
Phone
5632854803 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Chiropractic Medicine
Map
Address