Contract Details
Ancillary Care Services
Facility name
Knoxville Chiropractic Clinic
Provider ID
P000004943
NPI
1619012507
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
115 North Peters Road
Knoxville, TN 37923
United States
County
Knox
Phone
8656906898 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Chiropractic Medicine
Map
Address