Contract Details
Ancillary Care Services
Facility name
Ocean Ridge Chiropractic Center
Provider ID
P000004786
NPI
1548324213
Tax ID
650855899
Effective Date
4/1/2012
Last Updated
10/2/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
68.00
Location Details
Address
212 East Boynton Beach Boulevard
Boynton Beach, FL 33435
United States
County
Palm Beach
Phone
5617338500 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Chiropractic Medicine
Map
Address