Michael    Shaffer    DC
Contract Details
Ancillary Care Services
Facility name
Provider ID
P000004176
NPI
1275599896
Tax ID
592199292
Effective Date
4/1/2012
Last Updated
10/1/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
2663 Airport Road South Suite D-104
Naples, FL 34112
United States
County
Collier
Phone
2397933200 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Chiropractic Medicine
Map
Address