John  H  Wegmann    DC
Contract Details
Facility name
Provider ID
P000005641
NPI
1932133097
Tax ID
371413603
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
309 South Main St
Monmouth, IL 61462
United States
County
Warren
Phone
3097342447 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Chiropractic Medicine
Map
Address