Ronald  D  Dejong    DC
Contract Details
Facility name
Provider ID
P000005654
NPI
1932340809
Tax ID
752831464
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
2817 South Mayhill Rd Suite 100
Denton, TX 76208
United States
County
Denton
Phone
9403870474 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Chiropractic Medicine
Map
Address