Contract Details
Ancillary Care Services
Facility name
Family Care Chiropractic
Provider ID
P000005617
NPI
1922021575
Tax ID
611375745
Effective Date
4/1/2012
Last Updated
10/10/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
68.00
Location Details
Address
1679 Old Preston Highway North Suite 6
Louisville, KY 40229
United States
County
Jefferson
Phone
5029571021 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Chiropractic Medicine
Map
Address