Contract Details
Optimal Healing Chiropractic
Facility name
Traveling Chiro Guru
Provider ID
P000009366
NPI
1346594314
Tax ID
813225509
Effective Date
7/12/2019
Last Updated
7/18/2019
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
16 Office Park Circle Suite 8
Mountain Brook, AL 35223
United States
County
Jefferson
Phone
2059497650 (Phone)
Billing Details
Address
16 Office Park Circle
Suite 8
Mountain Brook, AL 35223
Billing Phone
2059497650
Specialty Type
Chiropractic Medicine
Map
Address