Contract Details
Ancillary Care Services
Facility name
Innate Health Chiropractic
Provider ID
P000005591
NPI
1902940851
Tax ID
262715661
Effective Date
4/1/2012
Last Updated
10/25/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
1201 East Main Street Suite 270
Allen, TX 75002
United States
County
Collin
Phone
9723254456 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Chiropractic Medicine
Map
Address