Asa    Andrew    DC
Contract Details
Facility name
Provider ID
P000005201
NPI
1720146665
Tax ID
263903765
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
4535 Harding Pike Suite 210
Nashville, TN 37205
United States
County
Davidson
Phone
6152696355 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Chiropractic Medicine
Map
Address