Contract Details
Ancillary Care Services
Facility name
Larocca Chiropractic Center
Provider ID
P000005912
Tax ID
273017103
Effective Date
4/1/2012
Last Updated
9/30/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
68.00
Location Details
Address
2288 Drew Street Suite C
Clearwater, FL 33765
United States
County
Pinellas
Phone
7277977090 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Chiropractic Medicine
Map
Address