Contract Details
Pomac Prosthetic & Orthotic Management
Facility name
Choice Limb & Brace, Inc
Provider ID
P000005814
NPI
1508840141
Tax ID
113154194
Effective Date
4/1/2012
Last Updated
10/23/2012
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
84.00
Location Details
Address
66 Main St
Dobbs Ferry, NY 10522
United States
County
Westchester
Phone
9144790743 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Orthotics/Prosthetics, Services
Map
Address