Contract Details
Facility name
Tillman's Corner Chiropractic
Provider ID
P000002476
Tax ID
630924886
Effective Date
10/1/2004
Last Updated
6/9/2016
Direct Contract
Yes
Term Date
9/3/2015
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
5369 Highway 90 Service Road Suite C
Mobile, AL 36619
United States
County
Mobile
Phone
2516610322 (Phone)
Billing Details
Address
5369 Highway 90 Service Road
Suite C
Mobile, AL 36619
Billing Phone
2516610322
Specialty Type
Chiropractic Medicine
Map
Address