Contract Details
Facility name
Avery Chiropractic
Provider ID
P000004863
NPI
1578612537
Tax ID
752787359
Effective Date
4/1/2012
Last Updated
10/23/2012
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
68.00
Location Details
Address
5204 South Colony Blvd Suite 160
The Colony, TX 75056
United States
County
Denton
Phone
9726246644 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Chiropractic Medicine
Map
Address