Contract Details
Ancillary Care Services
Facility name
Knoxville Chiropractic Clinic
Provider ID
P000004452
NPI
1407041833
Tax ID
570739233
Effective Date
4/1/2012
Last Updated
9/26/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
68.00
Location Details
Address
1713 Dry Gap Pike
Knoxville, TN 37918
United States
County
Knox
Phone
8656879797 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Chiropractic Medicine
Map
Address