Contract Details
Ancillary Care Services
Facility name
Fritz Orthotics & Prosthetics
Provider ID
P000003705
NPI
1053315622
Tax ID
582633829
Effective Date
4/1/2012
Last Updated
9/30/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
700 Oglethorpe Avenue Suite B-2
Athens, GA 30606
United States
County
Clarke
Phone
7064259000 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Orthotics/Prosthetics, Services
Map
Address