Contract Details
Ancillary Care Services
Facility name
Joshua Chiropractic Clinic
Provider ID
P000005031
NPI
1659462141
Tax ID
205341370
Effective Date
4/1/2012
Last Updated
10/22/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
611 North Broadway Street
Joshua, TX 76058
United States
County
Johnson
Phone
8174842707 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Chiropractic Medicine
Map
Address