Contract Details
Pomac Prosthetic & Orthotic Management
Facility name
La Torre Orthopedic Laboratory
Provider ID
P000006240
Tax ID
113154194
Effective Date
4/1/2012
Last Updated
10/23/2012
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
84.00
Location Details
Address
960 Troy Schenectady Rd
Latham, NY 12110
United States
County
Albany
Phone
8009469170 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Orthotics/Prosthetics, Services
Map
Address