Julie  K  Powell    DC
Contract Details
Facility name
Provider ID
P000004608
NPI
1467495465
Tax ID
752899751
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
1304 Village Creek Dr Suite 300
Plano, TX 75093
United States
County
Collin
Phone
9729316800 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Chiropractic Medicine
Map
Address