Contract Details
Ancillary Care Services
Facility name
Health Chiropractic Rehab & Wellness
Provider ID
P000003625
NPI
1013273176
Tax ID
454566411
Effective Date
4/15/2012
Last Updated
10/1/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
6273 Old Winter Garden Road
Orlando, FL 32835
United States
County
Orange
Phone
4072504814 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Chiropractic Medicine
Map
Address