Gary    Dunn    DC
Contract Details
Facility name
Provider ID
P000004582
NPI
1457389553
Tax ID
421208761
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
115 West Main St
Manchester, IA 52057
United States
County
Delaware
Phone
5639272961 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Chiropractic Medicine
Map
Address