Contract Details
Facility name
Manfre Chiropractic
Provider ID
P000005040
NPI
1669406310
Tax ID
752685543
Effective Date
4/1/2012
Last Updated
10/23/2012
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
68.00
Location Details
Address
3730 North Josey Ln Suite 122
Carrollton, TX 75007
United States
County
Denton
Phone
9724162000 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Chiropractic Medicine
Map
Address