Contract Details
Ancillary Care Services
Facility name
Miller Chiropractic
Provider ID
P000004874
NPI
1588658868
Tax ID
611210546
Effective Date
4/1/2012
Last Updated
10/10/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
2619 County Farm Road
London, KY 40741
United States
County
Laurel
Phone
6068626986 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Chiropractic Medicine
Map
Address