David  A  Sherdondy    DC
Contract Details
Facility name
Provider ID
P000005361
NPI
1790837284
Tax ID
421000664
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
3612 West Ave
Burlington, IA 52601
United States
County
Des Moines
Phone
3197545505 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Chiropractic Medicine
Map
Address