Contract Details
Ancillary Care Services
Facility name
Academy Orthotic & Prosthetic Associates
Provider ID
P000003898
NPI
1144220021
Tax ID
900427698
Effective Date
4/1/2012
Last Updated
10/9/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
1509 Prosperity Farms Road
Lake Park, FL 33403
United States
County
Palm Beach
Phone
9175927277 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Orthotics/Prosthetics, Services
Map
Address