David  J  Weber    DC
Contract Details
Facility name
Provider ID
P000004040
NPI
1215944632
Tax ID
363993047
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
289 Sinsinawa Ave
East Dubuque, IL 61025
United States
County
Jo Daviess
Phone
8157476548 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Chiropractic Medicine
Map
Address