E.H.    Cardwell    DC
Contract Details
Ancillary Care Services
Facility name
Provider ID
P000005436
NPI
1821192121
Tax ID
581484552
Effective Date
4/1/2012
Last Updated
9/30/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
1230 Johnson Ferry Place Suite G30
Marietta, GA 30068
United States
County
Cobb
Phone
7709779200 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Chiropractic Medicine
Map
Address