William    Leff    DC
Contract Details
Ancillary Care Services
Facility name
Provider ID
P000004150
NPI
1265536593
Tax ID
742531072
Effective Date
4/1/2012
Last Updated
10/31/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
3130 Montana Avenue
El Paso, TX 79903
United States
County
El Paso
Phone
9155669671 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Chiropractic Medicine
Map
Address