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Jeffrey
D
Fisher
DC
Contract Details
Facility name
Provider ID
P000004011
NPI
1205906070
Tax ID
752963356
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
320 Palo Pinto St
Weatherford, TX 76086
United States
County
Parker
Phone
8175941505
(
Phone
)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Chiropractic Medicine
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Address