Contract Details
Ancillary Care Services
Facility name
Tarpon Total Health Care
Provider ID
P000004266
NPI
1316971211
Tax ID
593497945
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
400 East Tarpon Avenue
Tarpon Springs, FL 34689
United States
County
Pinellas
Phone
7279340844 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Chiropractic Medicine
Map
Address