Contract Details
Facility name
Life Care Chiropractic
Provider ID
P000003920
NPI
1154415297
Tax ID
900119762
Effective Date
4/1/2012
Last Updated
10/23/2012
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
7844 Gateway East Suite A
El Paso, TX 79915
United States
County
El Paso
Phone
9155322273 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Chiropractic Medicine
Map
Address