Contract Details
Wheeler Chiropractic and Sports Injury
Facility name
Wheeler Chiropractic & Sports Injury
Provider ID
P000004667
NPI
1487847067
Tax ID
752967479
Effective Date
4/1/2012
Last Updated
10/23/2012
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
1101 West Bluff St
Woodville, TX 75979
United States
County
Tyler
Phone
4093842633 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Chiropractic Medicine
Map
Address