Contract Details
Ancillary Care Services
Facility name
Mahnke's Orthotics & Prosthetics
Provider ID
P000005843
Tax ID
592066233
Effective Date
4/1/2012
Last Updated
10/1/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
74.00
Location Details
Address
9045 La Fontana Boulevard Suite B14
Boca Raton, FL 33434
United States
County
Palm Beach
Phone
8662365172 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Orthotics/Prosthetics, Services
Map
Address