Contract Details
Facility name
O'Mary Chiropractic Clinic
Provider ID
P000002287
NPI
1235337320
Tax ID
201325808
Effective Date
7/1/1999
Last Updated
8/29/2014
Direct Contract
Yes
Term Date
3/4/2014
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
301 22nd Avenue East
Jasper, AL 35501
United States
County
Walker
Phone
2053845358 (Phone)
Billing Details
Address
3201 22nd Avenue East
Jasper, AL 35501
Billing Phone
2053845358
Specialty Type
Chiropractic Medicine
Map
Address