Contract Details
Ancillary Care Services
Facility name
Foundation Chiropractic Clinic
Provider ID
P000005639
NPI
1932105335
Tax ID
650647633
Effective Date
4/1/2012
Last Updated
10/2/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
68.00
Location Details
Address
1395 North Military Trail
West Palm Beach, FL 33409
United States
County
Palm Beach
Phone
5616840333 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Chiropractic Medicine
Map
Address