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Dwight
L
Agee
DC
Contract Details
ChiroPlus of Alabama
Facility name
Provider ID
P000000009
NPI
1225015688
Tax ID
630993590
Effective Date
5/14/1998
Last Updated
9/22/2014
Direct Contract
Yes
Term Date
9/22/2014
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
2811 Lurleen B. Wallace Boulevard Suite 12
Northport, AL 35476
United States
County
Tuscaloosa
Phone
2053393333
(
Phone
)
Billing Details
Address
2811 Lurleen B. Wallace Boulevard
Suite 12
Northport, AL 35476
Billing Phone
2053393333
Specialty Type
Chiropractic Medicine
Map
Address