Chiropractic Provider Request


If you wish to participate with DPSC as a Chiropractor provider for the DPSC Network. Please fax to us at 386-672-4811, on your letterhead, a request to participate or fill in the form below.

DPSC does not charge an application fee or credential fee for Chiropractors.

 

Name

Street

City State Zip

Phone Fax

Specialty   ID#

Email  


Copyright 2003    DPSC Inc.   All Rights Reserved
    Doctors Professional Services Consultants Chiropractic Network
Contact us at: D.P.S.C. Inc.  50 S. Perrott Drive  Ormond Beach, Florida 32174
Phone 386-615-0801   Fax 386-672-4811   e-mail: service@dpsc.info


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