Melissa    Munoz    DC
Contract Details
Ancillary Care Services
Facility name
Provider ID
P000004823
NPI
1558671545
Tax ID
273522515
Effective Date
4/1/2012
Last Updated
9/30/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
84.00
Location Details
Address
3201 Flagler Avenue
Key West, FL 33040
United States
County
Monroe
Phone
3058790046 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Chiropractic Medicine
Map
Address