Emil    Nardone    DC
Contract Details
Ancillary Care Services
Facility name
Provider ID
P000005261
NPI
1750426896
Tax ID
010687387
Effective Date
4/1/2012
Last Updated
10/21/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
101 Marshall Street
Benwood, WV 26031
United States
County
Marshall
Phone
3042431055 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Chiropractic Medicine
Map
Address