Chris    O'Laire    DC
Contract Details
Advanced Spine & Therapy, LLC
Facility name
Provider ID
P000008501
NPI
1215233564
Tax ID
465111567
Effective Date
9/6/2016
Last Updated
12/15/2016
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
627 South Saraland Blvd
Saraland, AL 36571
United States
County
Mobile
Phone
2516791995 (Phone)
Billing Details
Address
627 South Saraland Blvd
Saraland, AL 36571
Billing Phone
2516791995
Specialty Type
Chiropractic Medicine
Map
Address