Scott    Wofford    DC
Contract Details
Ancillary Care Services
Facility name
Provider ID
P000005646
NPI
1932188646
Tax ID
752396516
Effective Date
4/1/2012
Last Updated
6/9/2016
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
1750 South Clack Street
Abilene, TX 79605
United States
County
Taylor
Phone
3256952225 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Billing Phone
3256952225
Specialty Type
Chiropractic Medicine
Map
Address