Douglas    Hoad    DC
Contract Details
Facility name
Provider ID
P000005739
NPI
1972553154
Tax ID
452437848
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
34 North Water St
Batavia, IL 60510
United States
County
Kane
Phone
6307611314 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Chiropractic Medicine
Map
Address