Contract Details
Ancillary Care Services
Facility name
Stangherlin Clinics
Provider ID
P000003822
NPI
1104865484
Tax ID
593577545
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
8834 North 56th Street
Tampa, FL 33617
United States
County
Hillsborough
Phone
8139831400 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Chiropractic Medicine
Map
Address