Contract Details
Ancillary Care Services
Facility name
Atlanta Pain & Injury
Provider ID
P000003768
NPI
1073844205
Tax ID
271419822
Effective Date
4/1/2012
Last Updated
9/27/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
785 Virginia Avenue Suite B
Hapeville, GA 30354
United States
County
Fulton
Phone
7709382625 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Chiropractic Medicine
Map
Address