Carol    Korzi    DC
Contract Details
Ancillary Care Services
Facility name
Provider ID
P000005658
NPI
1942203831
Tax ID
550691835
Effective Date
4/1/2012
Last Updated
10/21/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
3681 Pennsylvania Avenue
Weirton, WV 26062
United States
County
Hancock
Phone
3047233330 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Chiropractic Medicine
Map
Address