Richard    Freesmeier    DC
Contract Details
Ancillary Care Services
Facility name
Provider ID
P000004902
NPI
1598767220
Tax ID
592208967
Effective Date
4/1/2012
Last Updated
10/1/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
68.00
Location Details
Address
2538 Capital Medical Boulevard
Tallahassee, FL 32308
United States
County
Leon
Phone
8508788242 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Chiropractic Medicine
Map
Address