Kelly  D  Clenney    DC
Contract Details
Facility name
Provider ID
P000004337
NPI
1356353346
Tax ID
752794365
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
3701 Olsen Blvd Suite D
Amarillo, TX 79109
United States
County
Randall
Phone
8063522976 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Chiropractic Medicine
Map
Address