Kara    Liebenauer    DC
Contract Details
Ancillary Care Services
Facility name
Provider ID
P000005448
NPI
1831176213
Tax ID
611297362
Effective Date
4/1/2012
Last Updated
10/10/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
820 Chuck Gray Court
Owensboro, KY 42303
United States
County
Daviess
Phone
2706855100 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Chiropractic Medicine
Map
Address