Contract Details
Ancillary Care Services
Facility name
Sonlife Prosthetics and Orthotics
Provider ID
P000004241
NPI
1306838792
Tax ID
592813168
Effective Date
4/1/2012
Last Updated
10/1/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
2024 Highway 44 West
Inverness, FL 34453
United States
County
Citrus
Phone
3525962257 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Orthotics/Prosthetics, Services
Map
Address