Contract Details
Ancillary Care Services
Facility name
Munday Chiropractic Center
Provider ID
P000004423
NPI
1396742003
Tax ID
611153950
Effective Date
4/1/2012
Last Updated
10/10/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
68.00
Location Details
Address
138 North Evergreen Road Suite 102
Louisville, KY 40243
United States
County
Jefferson
Phone
5022453599 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Chiropractic Medicine
Map
Address