Contract Details
Facility name
Boshell Family Chiropractic
Provider ID
P000002021
NPI
1356559843
Tax ID
680514866
Effective Date
10/1/2004
Last Updated
9/3/2015
Direct Contract
Yes
Term Date
9/3/2015
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
84 Highway 195 Suite A
Jasper, AL 35503
United States
County
Walker
Phone
2052219951 (Phone)
Billing Details
Address
84 Highway 195
Suite A
Jasper, AL 35503
Billing Phone
2052219951
Specialty Type
Chiropractic Medicine
Map
Address