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Contract Details
Ancillary Care Services
Facility name
Howard Chiropractic Center
Provider ID
P000005367
NPI
1790872778
Tax ID
593491329
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
7321 Dr. MLK, Jr. Street North
Saint Petersburg, FL 33702
United States
County
Pinellas
Phone
7275200303
(
Phone
)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Chiropractic Medicine
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Address