Contract Details
Facility name
MWB Health Services Inc
Provider ID
P000003872
NPI
1124298799
Tax ID
262052342
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
111 North State St
Marengo, IL 60152
United States
County
McHenry
Phone
8155689900 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Chiropractic Medicine
Map
Address