Philip  J  Sewell    DC
Contract Details
Facility name
Provider ID
P000004342
NPI
1356376594
Tax ID
351446162
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
1102 West Broadway
Loogootee, IN 47553
United States
County
Martin
Phone
8122952387 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Chiropractic Medicine
Map
Address