Contract Details
Ancillary Care Services
Facility name
Colony Chiropractic
Provider ID
P000003639
NPI
1023082724
Tax ID
450492528
Effective Date
4/1/2012
Last Updated
10/28/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
68.00
Location Details
Address
5000 Main Street Suite 203
The Colony, TX 75056
United States
County
Denton
Phone
9726254800 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Chiropractic Medicine
Map
Address