Contract Details
Ancillary Care Services
Facility name
Papa Chiropractic
Provider ID
P000004629
NPI
1477581445
Tax ID
650163644
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
2632 Indiantown Road
Jupiter, FL 33458
United States
County
Palm Beach
Phone
5617447373 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Chiropractic Medicine
Map
Address