Arold    Augustin    DC
Contract Details
Ancillary Care Services
Facility name
Provider ID
P000004304
NPI
1336244698
Tax ID
383855742
Effective Date
4/1/2012
Last Updated
9/30/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
4301 West Sunrise Boulevard
Plantation, FL 33313
United States
County
Broward
Phone
9545147712 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Chiropractic Medicine
Map
Address