John    Burley    DC
Contract Details
Ancillary Care Services
Facility name
Provider ID
P000006430
Tax ID
460511798
Effective Date
4/1/2012
Last Updated
9/26/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
205 Gifford Place
Joelton, TN 37080
United States
County
Davidson
Phone
6158769936 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Chiropractic Medicine
Map
Address