Contract Details
Facility name
Copeland Chiropractic Clinic
Provider ID
P000002064
NPI
1821158510
Tax ID
420568145
Effective Date
11/25/2002
Last Updated
8/26/2014
Direct Contract
Term Date
3/4/2014
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
412 1st Avenue Southeast Suite 103
Cullman, AL 35055
United States
County
Cullman
Phone
2567379450 (Phone)
Billing Details
Address
412 1st Avenue Southeast
Suite 103
Cullman, AL 35055
Billing Phone
Specialty Type
Chiropractic Medicine
Map
Address